{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T08:06:13Z","timestamp":1779782773871,"version":"3.53.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Tacrolimus monitoring is generally performed in whole blood (WB). Most (&gt;85%) of circulating tacrolimus is bound to red blood cells. During pregnancy, WB monitoring might be suboptimal because of physiological changes including increased plasma volume and decreased haematocrit. Therefore, plasma tacrolimus monitoring might better indicate potential dosage needs in pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective single\u2010centre cohort study aimed to assess and compare tacrolimus WB and plasma concentration\u2010to\u2010dose (C\/D) ratios before, during, and after pregnancy in kidney or liver transplant recipients. Linear mixed model analysis was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine women with 10 pregnancies were included. Based on WB tacrolimus concentrations, the median prescribed dosage significantly increased from 3 pre\u2010pregnancy to 7.5\u2009mg\/day (+150%) in the third trimester (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u2009.001). The correlation between plasma and WB tacrolimus concentrations decreased throughout pregnancy with a correlation coefficient of 0.70 in the first trimester, 0.41 in the second and 0.30 in the third trimester of pregnancy. Median WB tacrolimus C\/D ratios significantly decreased from 1.48 pre\u2010pregnancy to 0.58 in the second and third trimester (\u221261%) (overall time effect\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u2009.001). The effect of time became non\u2010significant after adjusting for haematocrit (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u2009.40). Median plasma tacrolimus C\/D ratios decreased from 0.03 pre\u2010pregnancy to 0.02 in the first trimester (\u221233%) and remained stable afterward (overall time effect\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.33) and was not affected by haematocrit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that increasing dosages targeting WB tacrolimus concentrations may not be necessary during pregnancy based on plasma tacrolimus concentrations. However, larger studies are needed to confirm the findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70454","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T13:05:18Z","timestamp":1769691918000},"page":"1876-1885","source":"Crossref","is-referenced-by-count":0,"title":["Tacrolimus exposure during pregnancy in kidney and liver transplantation recipients: A comparison between whole blood and plasma concentration\u2010to\u2010dose ratios"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3798-6443","authenticated-orcid":false,"given":"Jildau R.","family":"Meinderts","sequence":"first","affiliation":[{"name":"Department of Nephrology, Groningen Institute for Organ Transplantation University Medical Center Groningen, University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3551-1201","authenticated-orcid":false,"given":"Paola","family":"Mian","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen, University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6592-0694","authenticated-orcid":false,"given":"Frederike G. I.","family":"van Vilsteren","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Groningen Institute for Organ Transplantation University Medical Center Groningen, University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6075-5497","authenticated-orcid":false,"given":"Karien M. H.","family":"van de Wetering","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Groningen Institute for Organ Transplantation University Medical Center Groningen, University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3984-2163","authenticated-orcid":false,"given":"Jelmer R.","family":"Prins","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University Medical Center Groningen, University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2228-4676","authenticated-orcid":false,"given":"Stefan P.","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Groningen Institute for Organ Transplantation University Medical Center Groningen, University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daan J.","family":"Touw","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen, University of Groningen  Groningen the Netherlands"},{"name":"Department of Pharmaceutical Analysis, Groningen Research Institute for Pharmacy University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7347-4344","authenticated-orcid":false,"given":"Margriet F. C.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Groningen Institute for Organ Transplantation University Medical Center Groningen, University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.009029"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2014.00065"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2013.01.012"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2024.100842"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2015.01.002"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0041\u20101345(99)00788\u20105"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40262\u2010023\u201001259\u2010x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13309"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/000456329803500201"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchromb.2023.123709"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0b013e3182708edf"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics15102455"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318278d367"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chroma.2023.464086"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0b013e318192304c"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2022.09.029"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.12.023"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2016.03.045"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2017.01.049"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/bph.16179"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/bph.16179"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2015.04.041"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.2393"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.15886"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.12494"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.4149\/BLL_2019_060"}],"container-title":["British Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bcp.70454","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bcp.70454","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bcp.70454","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T07:47:37Z","timestamp":1779781657000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/10.1002\/bcp.70454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/bcp.70454"],"URL":"https:\/\/doi.org\/10.1002\/bcp.70454","archive":["Portico"],"relation":{},"ISSN":["0306-5251","1365-2125"],"issn-type":[{"value":"0306-5251","type":"print"},{"value":"1365-2125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,29]]}}}