Objective To establish a chain management model for pediatric living donor liver transplantation and to explore its clinical effect. Methods Historical control study design was adopted. Twenty-eight children who received orthotopic liver transplantation in the transplantation center from March 2020 through March 2021 were selected as the control group and received routine care. Between May 2021 and February 2022, another 30 children of the same kind were selected as the intervention group, and were subjected to a multidisciplinary team (MDT)-led chain management model which encompassed a trans-department major cycle and a within-department closed-loop minor cycle. Results Compared with the control group, the rates of hand-over omissions in major cycle and minor cycle in the intervention group were significantly reduced, while the rates of preoperative vaccination, and perioperative pain control, and satisfaction of caregivers, were significantly improved (all P<0.05). Conclusion The establishment and practice of the chain management model can reduce handover omissions in major cycle (between departments) and minor cycle (within departments), improve uptake of preoperative vaccination in children, solve the problems of perioperative pain, enhance caregiver satisfaction, and ensure the safety of perioperative nursing service.