{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T08:13:47Z","timestamp":1771661627135,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"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":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The pharmacokinetic implications of direct\u2010acting antiviral (DAA) use on tacrolimus posttransplant are unknown. This study sought to investigate the effects of glecaprevir\/pibrentasvir (G\/P), a CYP3A4 substrate and inhibitor, on weight\u2010adjusted tacrolimus (FK) trough\/dose ratio (T\/D) following heart or kidney transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This was a single\u2010center, retrospective analysis of hepatitis C virus (HCV) viremic donors to HCV negative heart or kidney transplant recipients who received 12\u00a0weeks of G\/P therapy. Weight\u2010adjusted T\/D was assessed while patients were at steady\u2010state before, during, and after G\/P treatment. Forty\u2010one HCV negative recipients (three heart, 38 kidney) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The weight\u2010adjusted T\/D significantly increased during G\/P treatment (119.31, IQR 88\u2013173.8) compared to before G\/P treatment (67.4, IQR 53.4\u2013115.9) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01), but decreased after completion of treatment (90.1, IQR 52.9\u2013122.7) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). There was no difference in weight\u2010adjusted T\/D before and after G\/P treatment (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.42). Four patients experienced acute rejection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Initiation of G\/P in heart or kidney transplant recipients induces a reversible change in tacrolimus metabolism. A 33%\u201350% tacrolimus dose reduction may be considered at the time of G\/P initiation. Regardless of tacrolimus dose adjustment, tacrolimus trough levels should be monitored 3 days after initiation of G\/P. No clear relationship between HCV viremic organ transplantation and rejection risk was found. Larger studies are warranted to validate these findings<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13716","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T16:26:58Z","timestamp":1629304018000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effect of glecaprevir\/pibrentasvir on weight\u2010adjusted tacrolimus trough\/dose ratios in heart and kidney transplant recipients"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7754-3922","authenticated-orcid":false,"given":"Daryl U.","family":"Nnani","sequence":"first","affiliation":[{"name":"Department of Pharmacy Montefiore Medical Center  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5722-9859","authenticated-orcid":false,"given":"Alesa","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Montefiore Medical Center  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2173-7568","authenticated-orcid":false,"given":"Maria","family":"Ajaimy","sequence":"additional","affiliation":[{"name":"Department of Medicine Montefiore Medical Center  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6432-0730","authenticated-orcid":false,"given":"Omar","family":"Saeed","sequence":"additional","affiliation":[{"name":"Division of Cardiology Montefiore Medical Center  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4987-051X","authenticated-orcid":false,"given":"Snehal R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Cardiology Montefiore Medical Center  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Montefiore Medical Center  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2054-1253","authenticated-orcid":false,"given":"Jay A.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Surgery Montefiore Medical Center  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9476-6466","authenticated-orcid":false,"given":"Ulrich P.","family":"Jorde","sequence":"additional","affiliation":[{"name":"Division of Cardiology Montefiore Medical Center  Bronx New York 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