Seven patients with symptomatic metastatic neuroendocrine tumours (6 carcinoids, 1 malignant insulinoma) were referred for liver transplantation. In 5 patients extrahepatic tumor dissemination demonstrated by octreotide scintigraphy contraindicated organ grafting. Due to absence of clinical symptoms, 1 patient is excluded from transplantation at present. Only 1 patient with liver metastases from lung carcinoid underwent transplantation. He is tumor free 10 months postoperatively. Liver transplantation may be regarded as an adequate therapeutic procedure in selected patients with metastatic carcinoids causing malignant carcinoid syndrome.