Pediatric liver transplantation is one of the great feats of modern medicine. It has evolved from an experiment bordering on futility into a standard of care with 1-year survival outcomes approaching 95%. Transplant allografts have proven to be incredibly durable; after more than 30 years of follow-up, we have not yet reached the median survival in pediatric liver transplantation.1 Since 1988, a total of 15 805 children (<18 years) have successfully undergone lifesaving liver transplants in the United States,2 and the number continues to grow.