Aim: To evaluate indications and outcomes of hypothermic oxygenated perfusion (HOPE) in a pediatric liver transplantation (PLT) program. Methods: A retrospective analysis was performed on pediatric recipients (3 weeks–18 years) who received HOPE-treated liver grafts (2024-2025). Indications  included prolonged cold ischemia time (>7 hours), atypical or ex-situ split graft reductions, and donation after circulatory death (DCD). Results: HOPE was used in  35/78 liver transplants. Median total cold preservation time (static cold storage plus HOPE) was 341 minutes (273–415), with a median HOPE duration of 105 minutes (93–129.5). Six grafts were from DCD donors, four were retransplants, one was a combined liver–kidney transplant, and one was an auxiliary split graft  from a DCD donor. Graft reduction was required in 28 cases, including 11 atypical reductions and 17 ex-situ split transplants, three neonates requiring  monosegment grafts. One multivisceral graft was converted to a liver graft during bench surgery. Overall patient survival was 94%; two deaths were due to causes unrelated to transplantation. Reperfusion was uneventful in all cases, with soft grafts and early bile production. A trend toward lower peak transaminase levels was observed in HOPE-treated grafts (p>0.05). Vascular/biliary complications occurred in 5.7%/11.5%  of patients, all surgically corrected. No ischemic cholangiopathy or cholangitis occurred. Initial primary graft dysfunction was observed in 44%, with normalization of transaminases by postoperative day three in 100%. Conclusion: HOPE is a safe and effective strategy and has become standard of care in our program for suboptimal, reduced, and complex pediatric liver grafts.