<p>The development of pediatric liver transplantation (LTx) is a&#xa0;success story. As an established standard treatment for acute and chronic liver diseases, liver tumors and hepatically localized metabolic diseases, it demonstrates excellent long-term survival. A&#xa0;prerequisite is the performance by experienced, specifically qualified, interdisciplinary treatment teams involving pediatricians, transplantation surgeons, nursing staff, intensive care specialists, anesthetists, radiologists, physiotherapists, dieticians, play therapists and social workers. Long-term survival rates of over 90% are achieved with a&#xa0;good quality of life at large specialized pediatric centers; however, the transplantation replaces the life-limiting underlying disease with a&#xa0;new chronic disease status. In view of this long-term perspective, the prevention and detection of complications after LTx are even more important. In addition to maintaining graft function, the focus of care must be on aspects of quality of life, rehabilitation, compliance, monitoring of treatment-associated side effects and transition. New innovative treatment options are constantly modifying the indications for LTx. The shortage of donor organs requires the optimal use of resources, including the sharing of all suitable organs. Extracorporeal machine perfusion allows donor livers to be optimized prior to LTx, thereby improving surgical outcomes.</p>