{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:44:58Z","timestamp":1791906298125,"version":"4.3.4"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early mycophenolic acid (MPA) exposure varies widely after kidney transplantation, and fixed initial mycophenolate mofetil (MMF) dosing may cause overexposure before therapeutic drug monitoring (TDM) becomes available. We explored routinely available pretransplant clinical variables and developed a simple pre\u2010TDM nomogram using triglycerides (TG) and body weight to support early postoperative MMF dose selection in tacrolimus\u2010treated recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010center retrospective derivation study, 117 consecutive adult kidney transplant recipients were screened, and 116 with complete concentration profiles were analyzed. All received tacrolimus\u2010based immunosuppression; none received cyclosporine. A model incorporating concurrent MMF dose, pretransplant body weight, and pretransplant TG was standardized to 1500\u00a0mg\/day. A three\u2010level rule (1000\/1500\/2000\u00a0mg\/day) was evaluated using dose\u2010proportional simulation. False discovery rate (FDR) correction, internal validation, and alternative dose\u2013exposure assumptions were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Observed MPA AUC categories were &lt;\u00a030, 30\u201360, and &gt;\u00a060\u00a0mg\u00b7h\/L in 12.1%, 46.6%, and 41.4% of recipients, respectively. TG survived dose\u2010adjusted multiplicity correction (\n                      <jats:italic>q<\/jats:italic>\n                      \u00a0=\u00a00.047), but not unadjusted correction. Under simulated nomogram\u2010guided dosing, the corresponding proportions were 14.7%, 54.3%, and 31.0%, a reduction in overexposure of 10.4 percentage points (bootstrap 95% confidence interval, \u221218.1\u2013\u22123.4). Across alternative assumptions, the reduction ranged from \u22121.7\u2013\u221210.4 percentage points and target\u2010attainment improvement was not robust; internal validation was directionally consistent but imprecise.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The nomogram showed a directionally consistent but assumption\u2010dependent reduction in simulated early MPA overexposure. It is a hypothesis\u2010generating pre\u2010TDM tool and should not replace AUC\u2010guided TDM or clinical judgment. Prospective external validation is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70696","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:47:12Z","timestamp":1791902832000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Triglyceride\u2010 and Body Weight\u2010Based Nomogram for Early Postoperative Mycophenolate Mofetil Dose Selection Following Kidney Transplantation"],"prefix":"10.1111","volume":"40","author":[{"given":"Tenshi","family":"Makiyama","sequence":"first","affiliation":[{"name":"Department of Frontier Surgery Graduate School of Medicine, Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Frontier Surgery Graduate School of Medicine, Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akane","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Frontier Surgery Graduate School of Medicine, Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiro","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Department of Frontier Surgery Graduate School of Medicine, Chiba University  Chiba 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