{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:08:08Z","timestamp":1781874488770,"version":"3.54.5"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T00:00:00Z","timestamp":1617408000000},"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":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Trough\u2010adjusted tacrolimus is commonly prescribed following intestinal transplantation to prevent allograft rejection. Despite established practice, there remains limited direct evidence linking tacrolimus levels with improved clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center review of all adult non\u2010liver containing intestinal allograft recipients from 2011 to 2018. Patients received lymphocyte depleting induction and maintenance immunosuppression consisting of tacrolimus and a corticosteroid taper. Tacrolimus time\u2010in\u2010therapeutic range (TAC\u2010TTR) was calculated for all patients from the date of transplant until 1\u2010year post\u2010transplant using Rosendaal's method. Cox\u2010Proportional hazards modeling was utilized to assess freedom from acute rejection and graft failure stratified by TAC\u2010TTR quartile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>47 patients were included in the review. Mean TAC\u2010TTR for the cohort was 30.2% \u00b1 11.4. Fifteen episodes of acute rejection were observed, 8 of which were severe. Patients in the highest TAC\u2010TTR quartile &gt;36% had a lower incidence of acute rejection and graft failure relative to patients with a TAC\u2010TTR &lt;20%. Cox\u2010Proportional hazards modeling found a 10% decrease in TAC\u2010TTR was associated with an increased hazard for acute rejection (2.03), severe acute rejection (2.19), and graft loss (3.33).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this study suggest that decreasing TAC\u2010TTR is a risk factor for both acute rejection as well as intestinal allograft failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14291","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T22:26:08Z","timestamp":1616192768000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Tacrolimus time\u2010in\u2010therapeutic range is associated with freedom from acute rejection and graft failure following intestinal transplantation"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4575-5330","authenticated-orcid":false,"given":"Andrew D.","family":"Santeusanio","sequence":"first","affiliation":[{"name":"Recanati\u2010Miller Transplantation Institute Mount Sinai Hospital New York NY USA"},{"name":"Department of Pharmacy Mount Sinai Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Gu","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan D.","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy Mount Sinai Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3564-6859","authenticated-orcid":false,"given":"Jang","family":"Moon","sequence":"additional","affiliation":[{"name":"Recanati\u2010Miller Transplantation Institute Mount Sinai Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishore R.","family":"Iyer","sequence":"additional","affiliation":[{"name":"Recanati\u2010Miller Transplantation Institute Mount Sinai Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12812"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04332.x"},{"key":"e_1_2_9_4_1","first-page":"1181","article-title":"Intravenous, oral pharmacokinetics, and oral dosing of FK 506 in small bowel transplant 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