{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:40:39Z","timestamp":1762940439887,"version":"3.45.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Though liver transplantation (LT) is effective for pediatric patients with end\u2010stage liver disease, it is associated with complications such as graft\u2010versus\u2010host disease (GVHD). In part due to its rarity and lack of standardized therapy, post\u2010LT GVHD is associated with a high mortality rate. While ruxolitinib (a JAK inhibitor) is approved for use in steroid\u2010refractory GVHD, its safety\/efficacy post\u2010LT is undefined. Thus, this case study reports the use of ruxolitinib in a pediatric patient with post\u2010LT GVHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 5\u2010month\u2010old male underwent a deceased donor left lateral segment LT with an induction regimen of corticosteroid and tacrolimus. Four weeks post\u2010LT, the patient developed skin GVHD. Ruxolitinib was administered in combination with tacrolimus and posaconazole, both capable of drug\u2013drug interactions with ruxolitinib via modulation of CYP3A4 activity. A pharmacokinetic (PK) study was conducted to evaluate the use of ruxolitinib to induce GVHD remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The ruxolitinib PK study revealed sufficient oral clearance and effective maximum serum concentration. Dosages of ruxolitinib, tacrolimus, and posaconazole were adjusted throughout the course of treatment based on GVHD severity (ruxolitinib) or their whole blood\/plasma concentrations (tacrolimus and posaconazole). By 18\u2009weeks after ruxolitinib initiation, skin GVHD lesions resolved and clinical remission was induced. The liver graft function was normal when assessed 40\u2009months after the initial presentation of GVHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This case illustrates the safe and effective\n                      <jats:styled-content style=\"fixed-case\">PK<\/jats:styled-content>\n                      \u2010validated use of ruxolitinib with tacrolimus and posaconazole to successfully induce remission of post\u2010\n                      <jats:styled-content style=\"fixed-case\">LT GVHD<\/jats:styled-content>\n                      in a pediatric patient.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70187","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T04:18:42Z","timestamp":1759465122000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacokinetic Monitoring of\n                    <scp>JAK<\/scp>\n                    Inhibitor and Tacrolimus for Safe and Effective Management of Graft\u2010Versus\u2010Host Disease After Pediatric Liver Transplantation"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-4589","authenticated-orcid":false,"given":"Keisuke","family":"Sawada","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Immunobiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Medical Scientist Training Program University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8627-6408","authenticated-orcid":false,"given":"Pooja","family":"Khandelwal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Bone Marrow Transplantation and Immune Deficiency Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stella M.","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Bone Marrow Transplantation and Immune Deficiency Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Crooker","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Translational and Clinical Pharmacology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Asai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Division of Gastroenterology, Hepatology, and Nutrition Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2024.01.014"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001406"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000260"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756\u20108722\u20105\u201050"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14205"},{"issue":"10","key":"e_1_2_11_7_1","article-title":"Graft\u2010Versus\u2010Host Disease in Paediatric Liver Transplantation: A Review of the Literature","volume":"107","author":"Kakotrichi A.","year":"2017","journal-title":"South African Medical Journal"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890\u2010200105270\u201000022"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15579"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002904"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2217\/imt\u20102017\u20100156"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/2040620720914489"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1917635"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409\u2010024\u201002252\u2010z"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0091270011405663"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2005.050047"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejps.2004.01.005"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2024.02.018"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.102"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.pharmtox.48.113006.094708"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/20406207221118429"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574884709666140520153308"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12183"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003252"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics2030291"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40262\u2010023\u201001225\u20107"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088\u2010198916030\u201000002"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00280\u2010022\u201004494\u20104"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2005.01110.x"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010023\u201000438\u20101"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70187","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:36:55Z","timestamp":1762940215000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,2]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/petr.70187"],"URL":"https:\/\/doi.org\/10.1111\/petr.70187","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"type":"print","value":"1397-3142"},{"type":"electronic","value":"1399-3046"}],"subject":[],"published":{"date-parts":[[2025,10,2]]},"assertion":[{"value":"2025-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70187"}}