INTRODUCTION: One in four liver transplants (LT) require return to the operating room(R-OR) within 48 hours of surgery. We hypothesize that donor, recipient, and intraoperative factors will predict R-OR. METHODS: LT recipients were enrolled in an observational study to measure coagulation with thrombelastography (TEG) were assessed with transplant recipient and donor variables for risk of R-OR. RESULTS: 160 recipients with a median age of 55 years and a MELD-Na of 22 were analyzed. R-OR occurred in 22%. Recipient BMI (p=0.006), donor heavy alcohol use (p=0.017), TEG MA (p=0.013) during the anhepatic phase of surgery, TEG MA at anhepatic and 30-minutes after reperfusion (p