Patients with severe alcoholic liver disease are receiving liver transplants in increasing numbers. Alcoholic liver transplant patients appear to have a good prognosis, yet alcoholic candidates may be rejected on psychiatric grounds alone. The role of the psychiatrist in the multidisciplinary assessment is discussed and the use of a number of predictors of outcome for alcoholic candidates considered. Studies examining these variables have many methodological limitations and it is therefore very difficult to draw any firm conclusions on their validity or reliability. Long-term prospective studies using appropriate measures of outcome should enable the liaison psychiatrist to provide more useful advice on the psychosocial outcome and treatment requirements of this growing group of patients.