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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 18, 2025; 15(4): 107462
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.107462
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.107462
Hyper-reduced grafts in living donor liver transplant: Techniques and outcomes
Soumyadip Sain, Shikhar Tripathi, Department of GI Surgery, Sir Ganga Ram Hospital, New Delhi 110060, India
Hirak Pahari, Suresh K Singhvi, Ushast Dhir, Department of Liver Transplant and Hepatobiliary Surgery, Sir Ganga Ram Hospital, New Delhi 110060, Delhi, India
Co-first authors: Soumyadip Sain and Hirak Pahari.
Author contributions: Sain S and Pahari H came up with the concept; Sain S conducted the initial literature search and removed duplicate entries; Pahari H, Tripathi S, Singhvi SK and Dhir U independently screened the remaining articles for eligibility based on the predefined criteria; Sain S, Pahari H, and Tripathi S addressed any discrepancies or conflicts regarding study eligibility until consensus was achieved; Pahari H, Tripathi S and Sain S performed the review and the meta-analysis; Sain S, Singhvi KS, and Dhir U helped in writing the manuscript; Pahari H and Sain S revised the manuscript.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hirak Pahari, MD, Department of Liver Transplant and Hepatobiliary Surgery, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi 110060, Delhi, India.
Received: March 24, 2025
Revised: May 14, 2025
Accepted: August 29, 2025
Published online: December 18, 2025
Processing time: 240 Days and 10.7 Hours
Revised: May 14, 2025
Accepted: August 29, 2025
Published online: December 18, 2025
Processing time: 240 Days and 10.7 Hours
Core Tip
Core Tip: Tailored graft reduction techniques—hyper-reduced, reduced, and monosegmental—effectively address graft size mismatch in pediatric liver transplantation. Optimal outcomes depend on careful donor selection, graft thickness adjustment, and individualized surgical planning. Vigilant attention to graft-to-recipient weight ratio and vascular anatomy minimizes complications. Long-term data confirm these techniques are safe, durable solutions for small pediatric recipients.