Objective To determine the risk factors for acute lung injury(ALI) early after orthotopic liver transplantation.Methods The perioperative clinical data of all 275 patients who had undergone orthotopic liver transplantation were analysed retrospectively.Several statistically significant risk factors were screened out with univarite analysis,then independent risk factors were determined with multivariate stepwise logistic regression analysis.Results Of the all 275 patients,the morbidity of ALI was 9.8% with a mortality of 22.2%.Univariate analysis showed that the occurrence of ALI was associated with preoperative infection,severe hepatitis,renal dysfunction,massive blood transfusion in operation,long non-hepatic period and long cold ischemic time.Multivarite stepwise logistic regression analysis revealed that the independent risk factors for ALI were massive blood transfusion in operation(OR=12.12,95%CI 0.958-25.364),longer non-hepatic period(OR=1.23,95%CI 1.034-1.410) and longer cold ischemic time(OR=22.35,95%CI 1.266-43.421).Conclusion Massive blood transfusion in operation,long non-hepatic period and long cold ischemic time were independent risk factors for ALI early after orthotopic liver transplantation.