*Purpose: Liver transplantation has been accepted as the appropriate treatment option for pediatric metabolic liver disease and the most common methods used are LDLT and DCD. Due to the low incidence of liver-based metabolic disease and low acceptance rates of LDLT in some countries, little research has been performed to compare the outcomes of the two operation methods for metabolic disease.

*Methods: Clinical data of 89 patients undergoing liver transplantation for the treatment of liver-based metabolic disorders were reviewed. pre- and peri-transplant demographics, post-transplant survival rate, early allograft dysfunction (EAD), virus infection, severe complications and laboratory test data were collected and analyzed.

*Results: For the 89 patients, only 2 of them died by the end of the last follow-up. The post-transplantation EAD rate and severe complications were different for LDLT and DCD. There was no significant difference between LDLT and DCD for the incidence of viral infections and the onset time of EBV and CMV infections either. In terms of laboratory indexes, the recovery time of PLT, AKP and AST levels were significantly different. Among the different types of metabolic disease, there was no significant difference found in viral infection, EAD, laboratory indexes, severe complications or duration of hospital stay.

*Conclusions: LDLT shows a lower incidence rate of EAD and complications, while it also shows a 1-year survival rate and incidence of viral infections compared similar to that of DCD. LDLT is the better treatment option of pediatric liver transplantation for metabolic liver disease compared with DCD.

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