{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:38:12Z","timestamp":1791567492834,"version":"4.3.4"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The left lateral sector (\n                      <jats:styled-content style=\"fixed-case\">LLS<\/jats:styled-content>\n                      ) from an adult donor is often the preferred option to provide a graft in pediatric liver transplantation (\n                      <jats:styled-content style=\"fixed-case\">pLT<\/jats:styled-content>\n                      ). It can result, however, in a challenge when transplanting small recipients given the size mismatch, jeopardizing the abdominal wall closure. The existing options in this scenario are closing with a temporary mesh (delayed abdominal closure) or the surgical modification of the graft, either a non\u2010anatomical reduction (NAR) or an anatomical segmentectomy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We present our experience altering ex\u2010situ the\n                      <jats:styled-content style=\"fixed-case\">LLS<\/jats:styled-content>\n                      and producing a Modified Segment 2 graft (\n                      <jats:styled-content style=\"fixed-case\">MS2<\/jats:styled-content>\n                      or almost complete\n                      <jats:styled-content style=\"fixed-case\">S3<\/jats:styled-content>\n                      exeresis) with the intention to reduce the incidence of temporary mesh closure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From January 2014 to 2024, 206\n                      <jats:styled-content style=\"fixed-case\">pLT<\/jats:styled-content>\n                      were done, including 67 recipients less than 10\u2009kg with an initial donor weight\u2010recipient weight ratio of 9 (\n                      <jats:styled-content style=\"fixed-case\">DWRWR<\/jats:styled-content>\n                      ). 42 were full\u2010\n                      <jats:styled-content style=\"fixed-case\">LLS<\/jats:styled-content>\n                      , 15 were\n                      <jats:styled-content style=\"fixed-case\">NAR<\/jats:styled-content>\n                      , and 10 were\n                      <jats:styled-content style=\"fixed-case\">MS2<\/jats:styled-content>\n                      . The\n                      <jats:styled-content style=\"fixed-case\">MS2<\/jats:styled-content>\n                      generated the smallest grafts (median of 195\u2009g), allowing it to reduce the initial Graft Weight\u2010Recipient Weight Ratio (\n                      <jats:styled-content style=\"fixed-case\">GWRWR<\/jats:styled-content>\n                      ) below 3.5. All but one patient in the\n                      <jats:styled-content style=\"fixed-case\">MS2<\/jats:styled-content>\n                      had a primary abdominal wall closure, a goal not obtained when using the full\u2010\n                      <jats:styled-content style=\"fixed-case\">LLS<\/jats:styled-content>\n                      or\n                      <jats:styled-content style=\"fixed-case\">NAR<\/jats:styled-content>\n                      . Postoperative outcomes for\n                      <jats:styled-content style=\"fixed-case\">MS2<\/jats:styled-content>\n                      were no different when compared with other grafts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In our experience, when transplanting recipients less than 10\u2009kg, ex\u2010situ\n                      <jats:styled-content style=\"fixed-case\">MS2<\/jats:styled-content>\n                      grafts can be produced safely and it facilitates primary abdominal wall closure, avoiding any further extra surgical procedure to achieve final abdomen closure.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70176","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T11:38:42Z","timestamp":1757677122000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Ex\u2010Situ Modified Segment 2 Graft After Left Lateral Sector Procurement in Pediatric Liver Transplantation: Farewell to Delayed Abdominal Closure?"],"prefix":"10.1111","volume":"29","author":[{"given":"Jose Andres","family":"Molino Gahete","sequence":"first","affiliation":[{"name":"Department of Paediatric, HPB Surgery and Liver Transplant Department, Vall D'hebron University Hospital  Barcelona Spain"},{"name":"Departament de Cirurgia, Facultat de Medicina, Universitat Autonoma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Dopazo","sequence":"additional","affiliation":[{"name":"HB Surgery and Liver Transplant Department Vall D'hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concepcion","family":"Gomez Guevara","sequence":"additional","affiliation":[{"name":"HB Surgery and Liver Transplant Department Vall D'hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Mercadal Hally","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology, Hepatology and Nutrition Vall D'hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Padros Fornieles","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology, Hepatology and Nutrition Vall D'hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Quintero Bernabeu","sequence":"additional","affiliation":[{"name":"Pediatric Hepatology and Liver Transplantation, ERN Rare Liver\u2014ERN TransplantChild, Hospital Vall D'hebron  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4680-9580","authenticated-orcid":false,"given":"Ernest","family":"Hidalgo Llompart","sequence":"additional","affiliation":[{"name":"Department of Paediatric, HPB Surgery and Liver Transplant Department, Vall D'hebron University Hospital  Barcelona Spain"},{"name":"HB Surgery and Liver Transplant Department, ERN TransplantChild Center Coordinator, Vall D'hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2003.08.024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15609"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24743"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14875"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14145"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000079446.94204.F9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14132"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.05.003"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25808"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/LVT.0000000000000091"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004644"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32223"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2022.09.015"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24976"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14872"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.21037\/hbsn\u201020\u2010792"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14417"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14283"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:37:15Z","timestamp":1762940235000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":18,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/petr.70176"],"URL":"https:\/\/doi.org\/10.1111\/petr.70176","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]},"assertion":[{"value":"2024-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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