{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:00:23Z","timestamp":1776254423920,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"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":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the association between tacrolimus intra\u2010patient variability (IPV) and the prognosis of cardiac transplant recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Tacrolimus trough concentrations (C\n                      <jats:sub>0<\/jats:sub>\n                      ) from cardiac transplant recipients were collected during the postoperative months 3\u20136. Dose\u2010adjusted IPV values were calculated, and recipients were divided into high\u2010IPV and low\u2010IPV groups. The composite endpoint was defined as the occurrence of any one of the following: infection, rejection, or mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 202 recipients were included. The incidence of infections was significantly higher in the high\u2010IPV group (34.8%\u00a0vs. 21.1%,\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a04.480,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.034). The risk of infection and composite endpoint occurrence was approximately 2.2 and 2.1 times higher, respectively, in the high\u2010IPV group than in the low\u2010IPV group, with hazard ratios (HR) and 95% CIs of 2.215 (1.175\u20133.842) and 2.061 (1.258\u20133.378). No significant differences were observed between the two groups in terms of rejection or mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.05). Cox regression analysis revealed that the relative risk of composite endpoint occurrence in the high\u2010IPV group was 2.024 times higher than in the low\u2010IPV group. The cumulative event\u2010free survival rates for the composite endpoint differed significantly between the two groups. Log\u2010rank testing of the survival curves yielded\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004 and HR\u00a0=\u00a02.061 (95% CI: 1.258\u20133.378).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cardiac transplant recipients with high tacrolimus IPV may be at increased risk of adverse events such as infections. Tacrolimus IPV, which is simple to calculate, can serve as a useful follow\u2010up tool for predicting postoperative adverse outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70427","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T08:55:13Z","timestamp":1767084913000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High Tacrolimus Intra\u2010Patient Variability and Adverse Outcomes in Cardiac Transplant Recipients: A Single\u2010Center Study in China"],"prefix":"10.1111","volume":"40","author":[{"given":"Zhenzhen","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine The Seventh People's Hospital of Zhengzhou  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine The Seventh People's Hospital of Zhengzhou  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine The Seventh People's Hospital of Zhengzhou  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yibo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine The Seventh People's Hospital of Zhengzhou  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunfei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Heart Transplantation Center The Seventh People's Hospital of Zhengzhou  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine The Seventh People's Hospital of Zhengzhou  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongxiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine The Seventh People's Hospital of Zhengzhou  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Heart Transplantation Center The Seventh People's Hospital of Zhengzhou  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6576-6449","authenticated-orcid":false,"given":"Lin","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine The Seventh People's Hospital of Zhengzhou  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"1271","article-title":"The Operation. 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