Liver transplantation in children offers a therapeutic alternative for severe liver disease. Post-transplantation five-year survival reaches 76%. At the moment this technique must be indicated as a controversial subject, which requires considering both the severity of liver disease and scarcity of donors, with unpredictable waiting time. We report our experience after the study of 57 children selected for liver transplant. Their diagnosis, clinical and functional stage, situations considered as contraindications, and pre-transplantation management aimed at supporting candidates during waiting time and to diminish avoidable risks after surgery, is described. During waiting time, 15.9% of the patients died. Post-transplantation actuarial survival in our center is 63.6% (January 1986 to November 1988). Survival has markedly improved, reaching 81%, in the last 23 months in relation to a prophylactic approach of cytomegalovirus disease and performance of retransplantation in cases of severe graft dysfunction.