{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:04:07Z","timestamp":1790381047596,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Liver transplantation in children weighing &lt;\u20098\u2009kg carries a high risk of graft\u2013recipient size mismatch, particularly excessive graft anteroposterior (AP) thickness, which may impair abdominal closure and graft perfusion. Graft thickness reduction (TR) has been proposed to address this issue; however, objective criteria guiding its indication remain poorly defined. This study compared outcomes between thickness\u2010reduced grafts and left lateral segment (LLS) grafts and explored factors associated with TR use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 79 primary living\u2010donor liver transplants performed in recipients weighing &lt;\u20098\u2009kg between January 2017 and July 2025. Patients were divided into LLS\/standard\u2010reduced LLS (LLS\/SR\u2010LLS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946) and thickness reduction by anterior hepatic resection (TR\u2010AHR,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933). Recipient, donor, intraoperative, and postoperative variables were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Recipients in the TR\u2010AHR group were younger, while body weight and PELD were similar between groups. Donors in the TR\u2010AHR group were more frequently male and had higher body weight and BMI. TR\u2010AHR achieved significantly lower final graft weight, graft\u2010to\u2010recipient weight ratio, and AP diameter. Rates of primary abdominal closure, ICU and hospital length of stay, vascular and biliary complications, and patient survival were comparable. Donor male sex, higher donor body weight and BMI, increased DWRWR, larger estimated AP diameter, and higher estimated GRWR were associated with TR\u2010AHR use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TR\u2010AHR is a safe and effective strategy to manage graft\u2013recipient size mismatch in recipients &lt;\u20098\u2009kg, achieving favorable graft dimensions without increasing morbidity. Identified variables should be interpreted as practical markers rather than formal selection criteria. Larger multicenter studies are needed to define standardized indications and long\u2010term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70443","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:38:07Z","timestamp":1787827087000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thickness Reduction Versus Conventional Left Lateral Sector Strategies in Children Below 8\u2009kg Undergoing Living Donor Liver Transplantation"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-1077","authenticated-orcid":false,"given":"Carolina Magalh\u00e3es","family":"Costa","sequence":"first","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-9533","authenticated-orcid":false,"given":"Eduardo Antunes","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1167-6829","authenticated-orcid":false,"given":"Renata Pereira Sustovich","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel Ruiz","family":"Benavides","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8576-440X","authenticated-orcid":false,"given":"Nath\u00e1lia Rangel Porto","family":"Travassos","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7644-3372","authenticated-orcid":false,"given":"Debora Puzzi","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0274-6274","authenticated-orcid":false,"given":"Gilda","family":"Porta","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9400-6697","authenticated-orcid":false,"given":"Irene Kazue","family":"Miura","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Porta","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9195-4859","authenticated-orcid":false,"given":"Vera Baggio","family":"Danese","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliene Novais","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian Barbieri Victoria","family":"Borges","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Hospital S\u00edrio\u2010Liban\u00eas and Hospital Samaritano  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0614-7738","authenticated-orcid":false,"given":"F\u00e1bio Payao","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Radiology Hospital S\u00edrio\u2010Liban\u00eas  S\u00e3o Paulo 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