{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:23:40Z","timestamp":1791300220859,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"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":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To assess the true prevalence and the risk factors of augmented renal clearance (ARC) in critical orthotopic liver transplant (OLT) recipients and its impact on early aggressive pharmacokinetic\/pharmacodynamic (PK\/PD) target non\u2010attainment of continuous infusion (CI) beta\u2010lactams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>OLT recipients without renal dysfunction and undergoing one or more measured creatinine clearance (mCLCr) assessments in the first 30 days posttransplant were retrospectively included. Reliability of three different eGFR formulas (Cockcroft\u2013Gault, 2021, CKD\u2010EPI, and MDRD) in estimating mCLCr was tested. Univariate analyses compared the clinical features of ARC versus non\u2010ARC patients and the severity of the clinical conditions during ARC versus non\u2010ARC episodes in the whole cohort. In patients receiving CI beta\u2010lactam therapy, risk factors for early aggressive PK\/PD target non\u2010attainment were investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 450 critical OLT recipients, 112 were included. The true prevalence of ARC was 23.2%. ARC versus non\u2010ARC patients were younger (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.003), had lower MELD score (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001), received lower number of intraoperative blood transfusions (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.007), and had a lower need for venovenous bypass technique (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.024). ARC episodes occurred more frequently in patients having lower SOFA score (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.005) and lower median serum creatinine levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). None of the eGFR formulas properly estimated mCLCr. In the subset of 50 OLT recipients receiving 60 CI beta\u2010lactam treatment courses, ARC was the only factor associated with early aggressive PK\/PD target non\u2010attainment (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ARC is a quite prevalent condition among critical OLT recipients, which may hinder early aggressive PK\/PD target attainment when using standard beta\u2010lactams dosing regimens, regardless of delivery by CI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70237","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:49:48Z","timestamp":1778219388000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["ARC in Critical Ill OLT Recipients: True Prevalence, Risk Factors, and Impact on Early Aggressive PK\/PD Target Non\u2010Attainment of CI Beta\u2010Lactam Therapy for Posttransplant Gram\u2010Negative Infections"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-3779","authenticated-orcid":false,"given":"Milo","family":"Gatti","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna  Bologna Italy"},{"name":"Clinical Pharmacology Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6856-8936","authenticated-orcid":false,"given":"Riccardo","family":"De Paola","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Specialization School of Clinical Pharmacology and Toxicology Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3568-5973","authenticated-orcid":false,"given":"Matteo","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit Department for Integrated Infectious Risk Management IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2437-6323","authenticated-orcid":false,"given":"Cristiana","family":"Laici","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Medicine IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8567-3508","authenticated-orcid":false,"given":"Antonio","family":"Siniscalchi","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Medicine IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1264-0008","authenticated-orcid":false,"given":"Pierluigi","family":"Viale","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna  Bologna Italy"},{"name":"Infectious Diseases Unit Department for Integrated Infectious Risk Management IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6966-7167","authenticated-orcid":false,"given":"Federico","family":"Pea","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna  Bologna Italy"},{"name":"Clinical Pharmacology Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna 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