We read with great interest the article by Yang et al.[1] evaluating the effects of postoperative serum total cholesterol (sTC) changes on early allograft dysfunction and survival after living donor liver transplantation (LDLT). By multivariate regression analysis, they showed that patients with sTC <1.42 mmol/L on postoperative day 3 had 4.08-fold and 2.72-fold greater risks of developing allograft dysfunction and 90-day mortality, and patients with sTC <1.42 mmol/L had poorer overall recipient and graft survival rates at 1-, 3-, and 5-year compared with those with sTC ≥1.42 mmol/L. Thus, they concluded that postoperative sTC <1.42 mmol/L is an independent risk factor of short- and long-term adverse outcomes after LDLT. However, this is a retrospective study, which can introduce a number of potential confounders. Other than the limitations described in discussion section, we noted that some methodological issues seem important to avoid any optimistic interpretation or misinterpretation of results.