{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:11:39Z","timestamp":1787962299787,"version":"build-2784847793"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T00:00:00Z","timestamp":1588550400000},"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":["Nephrology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In Scotland, standard maintenance immunosuppression following kidney transplantation consists of mycophenolate (MPA), tacrolimus and prednisolone irrespective of recipient age. We analyzed the tolerability of this immunosuppression regimen and the association with transplant outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A national, multicentre retrospective analysis of patients transplanted in 2015 and 2016, comparing graft function, acute rejection, significant infection rates and immunosuppression dosing between patients aged 18 and 59\u2009years (Group 1) and \u226560\u2009years (Group 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 490 patients, 26% were aged \u226560\u2009years. Acute rejection (AR) rates at 1 year were 15% and 11% in Groups 1 and 2, respectively. Full\u2010dose MPA was poorly tolerated with 53% in Group 1 and 77% in Group 2 requiring dose reduction or cessation. Female gender and age\u2009\u226560\u2009years were independent predictors for MPA dose changes. One year following MPA dose reduction, AR risk was low (5%) in Group 2, however, those remaining on full dose MPA had a 79% increased rate of serious infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The majority of renal transplant recipients aged \u226560 fail to tolerate full\u2010dose MPA. In this group, MPA dose reduction is associated with low rejection rates, but full\u2010dose MPA is associated with high infection rates. We suggest that a tailored approach to immunosuppression in elderly recipients incorporating lower doses of MPA may be appropriate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13718","type":"journal-article","created":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T03:34:13Z","timestamp":1587612853000},"page":"566-574","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The impact of age on patient tolerance of mycophenolate following kidney transplantation"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2609-5485","authenticated-orcid":false,"given":"Trijntje J. W.","family":"Rennie","sequence":"first","affiliation":[{"name":"Renal Department NHS Lothian \u2010 Royal Infirmary Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Petrie","sequence":"additional","affiliation":[{"name":"Renal Department NHS Lothian \u2010 Royal Infirmary Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Metcalfe","sequence":"additional","affiliation":[{"name":"Renal Department NHS Lothian \u2010 Royal Infirmary Edinburgh  Edinburgh UK"},{"name":"The Scottish Renal Registry, Meridian Court ISD Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Walbaum","sequence":"additional","affiliation":[{"name":"Renal Department, NHS Grampian Aberdeen Royal Infirmary  Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Joss","sequence":"additional","affiliation":[{"name":"Renal Department, NHS Highland Raigmore Hospital  Inverness UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Barton","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna","family":"Marson","sequence":"additional","affiliation":[{"name":"Renal Department NHS Lothian \u2010 Royal Infirmary Edinburgh  Edinburgh UK"},{"name":"Division of Health Sciences The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc J.","family":"Clancy","sequence":"additional","affiliation":[{"name":"Department of Renal Transplantation NHS Great Glasgow and Clyde \u2010 Queen Elizabeth University Hospital  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna","family":"Henderson","sequence":"additional","affiliation":[{"name":"Renal Department NHS Lothian \u2010 Royal Infirmary Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie P.","family":"Traynor","sequence":"additional","affiliation":[{"name":"The Scottish Renal Registry, Meridian Court ISD Scotland  Glasgow UK"},{"name":"Department of Renal Transplantation NHS Great Glasgow and Clyde \u2010 Queen Elizabeth University Hospital  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin G.","family":"Geddes","sequence":"additional","affiliation":[{"name":"Department of Renal Transplantation NHS Great Glasgow and Clyde \u2010 Queen Elizabeth University Hospital  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Phelan","sequence":"additional","affiliation":[{"name":"Renal Department NHS Lothian \u2010 Royal Infirmary Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067411"},{"key":"e_1_2_6_3_1","unstructured":"RennieTJ PhelanPJ CampbellJ TraynorJ HendersonL MetcalfeW. Kidney Transplantation in the over 60's in Scotland 1996\u20102015. Dunblane Scotland.https:\/\/www.srr.scot.nhs.uk\/SRA\/Docs\/2017\/2017-Abstract-booklet.pdf."},{"key":"e_1_2_6_4_1","volume-title":"Scottish Renal Registry Report 2016","author":"NHS National Services Scotland","year":"2016"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2009.07.007"},{"key":"e_1_2_6_6_1","unstructured":"Office for National Statistics. Deaths registered in England and Wales (series DR). October2017:22."},{"key":"e_1_2_6_7_1","unstructured":"Centre for Disease Control and Prevention. LCWK3. Deaths percent of total deaths and death rates for the 15 leading causes of death in selected age groups by race and Hispanic origin and sex: United States 2016.wwwCDC.gov.2016:65."},{"key":"e_1_2_6_8_1","unstructured":"NRScotland.gov.uk. Population of Scotland.https:\/\/www.nrscotland.gov.uk\/statistics\u2010and\u2010data\/statistics\/scotlands\u2010facts\/population\u2010of\u2010scotland."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-6-199903160-00002"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14107"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw668"},{"key":"e_1_2_6_13_1","unstructured":"ERA\u2010EDTA. ERA\u2010EDTA cause of death codes: SMARRT death code groups. Scottish Renal Registry\u2014ERA\u2010EDTA cause of death codes.https:\/\/www.srr.scot.nhs.uk\/Projects\/PDF\/Cause-of-Death-Codes-and-Groups_for-SRR-website.pdf."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2005.00359.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-3274(02)00058-8"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2007.00734.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2001.0590041539.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181734b4a"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200107150-00014"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1P456"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31817fdddb"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnep.13718","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.13718","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.13718","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.13718","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T12:45:26Z","timestamp":1694004326000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.13718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,4]]},"references-count":20,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/nep.13718"],"URL":"https:\/\/doi.org\/10.1111\/nep.13718","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,4]]},"assertion":[{"value":"2019-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}