Introduction: Since 2018 pediatric recipients have benefitted from the preferential allocation of grafts sourced from donors under 35 and national liver splitting policies. Our aim was to analyze the policy’s impact on waiting time and waitlist morbidity. 
Methods: A retrospective analysis of the waiting time and waitlist morbidity in 196 pLTs performed at our center between 2012-2023. Thirty-two urgent or combined liver transplants were excluded. Waitlist morbidity was defined as pLT-indication-specific decompensating events that required hospital admission and treatment whilst waitlisted, including: ascites, gastrointestinal bleeding, cholangitis, dyselectrolytemias, hyperammonemia or the need for extra cycles of chemotherapy. 
Results: Sixty-three patients (30 female/33 male) waited a median time of 112 days (IQR 70-2120) to receive their corresponding grafts between 2012-2017: 26 were sourced from living donors (LDLT) and 37 from cadaveric donors (DDLT), of which only 2 were split liver grafts (3.2%). From 2018-2023, 95 patients (49 female/46 male) waited a median of 32 days (IQR 12-79) to receive 101 grafts (8 LDLT and 93 DDLT, 40.6% of which were split grafts), resulting in a reduced overall waiting time (p=<0.05), together with an improved waitlist morbidity in the overall (41.3% versus 19.8) and subgroup analyses for recipients with cholestatic liver diseases (44.1% versus 18%) and liver tumors (80% versus 12.5%). No waitlist mortality was recorded. 
Conclusion: The implementation of our national liver splitting policy has led to a statistically significant reduction in waiting time and waitlist morbidity.