The scientific literature provides little evidence-based guidance in amount (quantitative fluid intervention) or type (qualitative fluid intervention) of fluid to optimize outcomes during liver and renal transplantation. Fluid intervention and vasoactive pharmacological support for transplantation depend on clinician preference, institutional resources and practice culture. Patients undergoing liver and renal transplantation should be managed on an individualized basis. No single approach will be effective. This chapter provides a contemporary overview of the fundamental principles underpinning fluid intervention for adult liver and renal transplantation. The overarching principles of fluid intervention for transplantation are to normalize the microcirculation by maintaining intravascular volume, tissue perfusion and tissue oxygenation, thereby protecting the new graft and other organs. The chapter also summarizes contemporary recommendations from expert panels for the perioperative fluid management and outcomes for adults undergoing liver and kidney transplantation.