Early extubation after liver transplantation is recommended by the Enhanced Recovery After Surgery Society (ERAS guideline 2022) as the benefit to avoid prolonged mechanical ventilation and associated complications. The timing of extubation is challenged by early postoperative hypoxia due to both preoperative and surgical status. Timely identifying the cause of hypoxia, typically including hepatopulmonary syndrome (HPS), pulmonary edema, atelectasis, and effusion is critical to prevent delayed extubation, especially in cases with HPS. As a radiation-free bedside approach, electrical impedance tomography (EIT) facilitates real-time lung ventilation and perfusion(V/Q) monitoring, however, the applicability of EIT V/Q monitoring for the assessment of HPS and its value for the management of hypoxia after liver transplantation has never been reported. Under this context, we took the lead in monitoring V/Q with EIT for a 12-year-old girl diagnosed with HPS who suffered intra and post liver transplantation hypoxia at the bedside. Our image raises key points for physicians that: 1) V/Q measurement of intrapulmonary shunts with bedside EIT holds the potential to identify HPS, a novel application that requires clinical validation. 2) EIT helps timely identify hypoxia after liver transplantation to support early individualized respiratory interventions. To our knowledge, V/Q monitoring by EIT is increasingly used in respiratory therapy, especially for ARDS PEEP titration, pulmonary embolism detection and lung transplantation assessment. However, The potential of EIT in liver transplant patients has been rarely studied. Our images might provide a novel and convenient approach to diagnosis HPS at bedside and offer new clinical applications for EIT imaging techniques.