<p>The treatment of patients with liver diseases represents an important challenge in the German healthcare system. The strategy of centralization of complex surgical interventions has the aim to improve the quality of treatment, to optimize postoperative outcomes and to minimize complications by the bundling of professional competence, infrastructure and resources. Although centralization has the potential to improve the results of treatment, it is simultaneously accompanied by substantial challenges with respect to availability of resources, hospital structures and personal treatment. A thorough planning and sufficient investments are necessary so that this strategy can sustainably be implemented in the practice.</p>