Introduction: By 2025, there were 229 patients awaiting a liver transplant in Mexico. In a country with an organ donation rate of 2.5%, the need to implement living donor transplantation arises. In addition, improved survival of living donor grafts has been observed after overcoming the learning curve associated with the early initiation period of living donor programs.

Method: An observational, cross-sectional, descriptive, retrospective study was conducted. Pediatric patients who underwent living donor liver transplantation in 2025 were selected. Relevant data were extracted from medical records for descriptive analysis.

Results: Five living donor pediatric liver transplants were performed over the course of one year. The patients ranged in age from 1 to 9 years. The main etiologies requiring transplantation were hepatoblastoma (40%), biliary atresia (20%), metabolic diseases (tyrosinemia, 20%), and familial intrahepatic cholestasis (20%). All donors were related relatives, and the left lateral segment of the mother's liver was primarily used for grafting, guided by three-dimensional models. The main complication was stenosis of the bilioenteric anastomosis (40%), requiring surgical reintervention. The longest follow-up period for patients is almost one year, and the shortest is one month; all are currently alive, as well as the donors, and have adequate liver function.

Conclusion: Living donor liver transplantation is a viable alternative in countries with a wide gap between patients on waiting lists and available organs. This is the first pediatric living donor liver transplant program implemented in Mexico, currently showing good medium-term results.