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Background: Domino transplant occurs when a recipient explanted graft is used for a second recipient. Introduction: The first experience came from thoracic surgery by the observation that many patients during heart-lung transplantation actually showed a functional heart that could be employed in other subjects with a good result. Results: This concept was then extended to the field of liver transplantation. At present, some patients transplanted for an inborn metabolic disease may be considered as excellent domino liver donors. Conclusion: The results, limitations, clinical challenges and the donor and recipient features of domino liver transplantation are discussed in this manuscript.