Liver volume matching in liver transplantation is important. Advances have been obtained to avoid small-for-size grafts, but management of large grafts remains a major challenge in this setting. Consequences include difficult anastomosis, poor vascular alignment, difficult wound closure, graft compression, and necrosis. Negative wound therapy allows a rapid closure of abdominal wall and salvage of the graft. In addition, preservation of the native inferior vena cava using a large graft during adult whole liver transplantation is associated with potential risk of hepatic venous outflow compression/obstruction. Intraoperative placement of materials to restore adequate hepatic venous outflow can overcome this complication. Placement of inflatable materials leads to gradual deflation in the postoperative period, which might obviate the need for reoperation.