A 51-year-old woman with polycystic liver and kidney disease had undergone renal transplantation 21 years before presentation. Both her father and aunt also had polycystic kidney disease. After the renal transplantation, her liver had become progressively diseased and enlarged through cystic changes. Early satiety, malnutrition, and abdominal pain necessitated a liver transplantation. White arrow - polycystic liver Black arrow - liver for transplant