Organ transplantation has emerged as a therapeutic modality for children with end-stage organ failure. With advancements in surgical techniques, organ preservation methods, and immunosuppressive therapies, both the success rate of transplantation and the long-term quality of life of recipients have continued to improve. Initially applied primarily in cardiothoracic transplantation, extracorporeal membrane oxygenation (ECMO) has gradually expanded its role in pediatric organ transplant recipients to include perioperative support for cardiopulmonary complications in abdominal organ transplants such as liver and kidney, as well as in the maintenance of deceased donors. With ongoing refinements in ECMO technology and equipment, its significance in supporting children with end-stage organ failure has become increasingly prominent, offering renewed hope and survival for a growing number of pediatric patients with organ failure.