Liver transplantation is the treatment of choice for chronic liver disease. While quality of life has been reported to increase following liver transplantation, living with a transplanted organ of offers many challenges to recipients including the spiritual challenge of finding meaning and purpose in the transplant experience. Self-transcendence, a complex developmental process reflecting spiritual growth and maturity, is associated with positive life outcomes. The purpose of this correlational cross-sectional design study (N = 471) was to explore relationships between self-transcendence and quality of life, illness distress, and selected demographic variables in liver transplant recipients. Significant relationships were noted between self-transcendence and quality of life (r = .51), illness distress (r = - .36), self-reported health status (tau = .28), female gender (tau = .11), being employed (tau = .11), and time-since-transplant (r = - .11). Females reported higher self-transcendence scores across all time-since-transplant groups. Results suggest self-transcendence views and behaviors, which develop during the crisis of liver transplantation, may facilitate positive outcomes. [ABSTRACT FROM AUTHOR]