Early liver transplantation for severe alcoholic hepatitis has recently been demonstrated to be a feasible and effective therapy for highly selected patients who fail medical therapy and violate the so-called “6 month rule,” using a rigorous evaluation program. Here at Mount Sinai, we are leading the North American experience of early liver transplantation as a rescue therapy for selected patients with severe alcoholic hepatitis. Particular areas of interest include patient selection, outcomes, burden on organ supply and alcohol relapse. Translational collaborations are being planned with the Alcoholic Liver Disease Research Center at Mount Sinai to further elucidate the pathogenesis of alcoholic hepatitis. Future clinical trials to evaluate therapies with less side-effects, more targeted therapies or those aimed hepatic regeneration are needed.