Children are dying on the organ transplant waitlist in the U.S. due to outdated policies that disadvantage pediatric candidates, despite advancements in medical technology like liver splitting. The author, a mother who experienced this firsthand with her son's biliary atresia, highlights that current U.S. policy, largely governed by the 1984 National Organ Transplant Act, fails to adequately address the unique needs of children. While efforts to modernize the system are underway, the existing allocation formulas and lack of regulation for technological innovations mean many children, especially those without living donors, are not receiving timely transplants. Other nations have successfully implemented policies prioritizing children, leading to near-elimination of pediatric waitlist mortality, a stark contrast to the ongoing tragedies in the U.S.