{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:44:16Z","timestamp":1761061456570,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"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":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Mycophenolate mofetil (MMF), the prodrug of mycophenolic acid, is a highly effective immunosuppressive agent in heart transplant therapy. While the FDA approved dose is 1500 mg twice daily, dosing is often reduced due to dose\u2010dependent adverse effects. However, empiric MMF dose reductions may lead to sub\u2010therapeutic dosing and impair clinical outcomes. Our single center protocolized a risk\u2010stratified approach based on age and weight to dose 500 mg twice daily or 1000 mg twice daily to patients after heart transplantation. This retrospective single\u2010center study analyzed 140 consecutive heart transplant patients who were initiated on our risk\u2010stratified MMF protocol post\u2010transplant. The analysis revealed that the composite rate of biopsy\u2010proven rejection, graft loss, or mortality at 1\u2010year post\u2010transplantation was similar between the two groups. Incidence of neutropenia, thrombocytopenia, infection, cardiac allograft vasculopathy, or acute kidney injury by 1\u2010year also showed similar results between the two groups. Risk\u2010stratification of MMF dosing appears to be a safe and effective strategy after heart transplantation.<\/jats:p>","DOI":"10.1111\/ctr.14445","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T02:49:21Z","timestamp":1627440561000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of risk\u2010stratified mycophenolate dosing in heart transplantation"],"prefix":"10.1111","volume":"35","author":[{"given":"Amit","family":"Alam","sequence":"first","affiliation":[{"name":"Center for Advanced Heart and Lung Disease Baylor Annette C. and Harold C. Simmons Transplant Institute Baylor University Medical Center, Dallas, Texas, USA; Division of Cardiology, Department of Advanced Heart Failure, Mechanical Support, and Transplant, Baylor Heart and Vascular Hospital, Dallas, Tex; Texas A&amp;M University College of Medicine  Bryan Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna S.","family":"Van Zyl","sequence":"additional","affiliation":[{"name":"Baylor Scott &amp; White Research Institute  Dallas Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelley A.","family":"Hall","sequence":"additional","affiliation":[{"name":"Center for Advanced Heart and Lung Disease Baylor Annette C. and Harold C. Simmons Transplant Institute Baylor University Medical Center, Dallas, Texas, USA; Division of Cardiology, Department of Advanced Heart Failure, Mechanical Support, and Transplant, Baylor Heart and Vascular Hospital, Dallas, Tex; Texas A&amp;M University College of Medicine  Bryan Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teena","family":"Sam","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Baylor University Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a015636"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(99)00259-6"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2013.09.004"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2015.02.005"},{"volume-title":"Cellcept [package insert]","year":"2019","key":"e_1_2_8_6_1"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1053-2498(03)00186-4"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200111270-00015"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2005.02.002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0012.2003.00026.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2005.00421.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.05.034"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2008.06.045"},{"key":"e_1_2_8_14_1","first-page":"63","article-title":"Individualized immunosuppression in transplant patients: potential role of pharmacogenetics","volume":"5","author":"Abboudi H","year":"2012","journal-title":"Pharmgenomics Pers Med"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2016.02.002"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.10.012"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199808270-00016"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01290.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318277e378"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199834060-00002"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.2003.00079.x"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14445","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.14445","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T10:15:38Z","timestamp":1692958538000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.14445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,6]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1111\/ctr.14445"],"URL":"https:\/\/doi.org\/10.1111\/ctr.14445","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"type":"print","value":"0902-0063"},{"type":"electronic","value":"1399-0012"}],"subject":[],"published":{"date-parts":[[2021,8,6]]},"assertion":[{"value":"2020-11-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14445"}}