Tommaso Maria Manzia, Roberta Angelico, Luca Toti, Cristina Angelico, Claudia Quaranta, Alessandro Parente, Francesca Blasi, Samuele Iesari, Daniele Sforza, Leonardo Baiocchi, Jan Lerut, Giuseppe Tisone – 20 August 2018 – Lifelong immunosuppression (IS) after liver transplantation is associated with severe adverse effects and increased recipients’ morbidity and mortality. Clinical operational tolerance has been reported in up to 40% in very well‐selected recipients. Longterm survival and cost savings within the Italian national health system in operational tolerant recipients is reported.