Cholinesterase is a serum enzyme synthesized mainly by the hepatocyte. Serum cholinesterase levels tend to decrease in time in patients with chronic liver failure and can indicate the intensity of liver failure. The lower the value of serum cholinesterase, the higher the possibility of liver failure. A reduction in liver function induced a drop in the level of serum cholinesterase. We present a patient with end-stage alcoholic cirrhosis and severe liver failure that received a liver transplant from a deceased donor. We compared blood tests and serum cholinesterase before and after the liver transplant. The hypothesis is that the value of serum cholinesterase increases after a liver transplant, and we noticed a significant increase in cholinesterase levels after the transplant. Serum cholinesterase activity increases after a liver transplant and it indicates that the liver function reserve will reach a higher level after the transplant, according to the new liver function reserve.