{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:28:45Z","timestamp":1783358925627,"version":"3.54.6"},"reference-count":26,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Prog Transpl"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Few studies have compared within-patient variability measures of tacrolimus trough levels by formulation and assessed within-patient variability on outcomes of kidney transplant recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Questions<\/jats:title>\n                    <jats:p>(1) To compare within-patient variability of trough levels when converting from twice-daily to once-daily tacrolimus using standard deviation, coefficient of variation, and intrapatient variability percent. (2) To use the 3 measures of variability to examine the relationship between tacrolimus once-daily within-patient variability and total graft failure (i.e., return to chronic dialysis, pre-emptive retransplant, death with graft function).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>In this observational cohort study, within-patient variability of trough levels pre- and post-conversion from twice-daily to once-daily tacrolimus were compared using Wilcoxon matched-pairs signed-rank test. Graft outcomes were analyzed using Kaplan-Meier curves and multivariable Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 463 patients, within-patient variability differences pre- and post-conversion of median standard deviation, coefficient of variation, and intrapatient variability percent were \u22120.16 ( P\u2009=\u20090.09), \u22120.01 ( P\u2009=\u20090.52), and \u22121.41 ( P\u2009=\u20090.32), respectively. Post-conversion, every 1 unit increase in within-patient variability standard deviation and intrapatient variability percent and every 0.1 unit increase in the coefficient of variation was associated with an increased hazard ratio [1.19 ( P\u2009=\u20090.004), 1.02 ( P\u2009=\u20090.030), 1.13 ( P\u2009=\u20090.001), respectively] of total graft failure. Post-conversion, within-patient variability above cohort medians using standard deviation and coefficient of variation had a significantly higher risk of total graft failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Under a program-wide conversion, no significant difference was observed in within-patient variability post-conversion from twice-daily to once-daily tacrolimus using the three measures of variability. High within-patient variability was associated with adverse transplant outcomes post-conversion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15269248221145044","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T03:13:39Z","timestamp":1671765219000},"page":"34-42","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Tacrolimus Formulation, Exposure Variability, and Outcomes in Kidney Transplant Recipients"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1046-5648","authenticated-orcid":false,"given":"Elaine F.","family":"Lai","sequence":"first","affiliation":[{"name":"Ajmera Transplant Center, Toronto General Hospital, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9804-819X","authenticated-orcid":false,"given":"Huong Thao","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Ajmera Transplant Center, Toronto General Hospital, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0826-0133","authenticated-orcid":false,"given":"Olusegun","family":"Famure","sequence":"additional","affiliation":[{"name":"Ajmera Transplant Center, Toronto General Hospital, University Health Network, Toronto, Canada"},{"name":"Division of Nephrology and the Kidney Transplant Program, Toronto General Hospital, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Li","sequence":"additional","affiliation":[{"name":"Ajmera Transplant Center, Toronto General Hospital, University Health Network, Toronto, Canada"},{"name":"Division of Nephrology and the Kidney Transplant Program, Toronto General Hospital, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Joseph","family":"Kim","sequence":"additional","affiliation":[{"name":"Ajmera Transplant Center, Toronto General Hospital, University Health Network, Toronto, Canada"},{"name":"Division of Nephrology and the Kidney Transplant Program, Toronto General Hospital, University Health Network, Toronto, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"bibr1-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2014530"},{"key":"bibr2-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1111\/aor.13551"},{"key":"bibr3-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000000755"},{"key":"bibr4-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3182292426"},{"key":"bibr5-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000136"},{"key":"bibr6-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000437561.31212.0e"},{"key":"bibr7-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2020.1803277"},{"key":"bibr8-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.465"},{"key":"bibr9-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq096"},{"key":"bibr10-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1111\/cts.13206"},{"key":"bibr11-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2019.02.065"},{"key":"bibr12-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2004.12.222"},{"key":"bibr13-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-84868-5"},{"issue":"2","key":"bibr14-15269248221145044","first-page":"393","volume":"32","author":"Rozen-Zvi B","year":"2017","journal-title":"Nephrol Dial Transplant"},{"key":"bibr15-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcmf.2013.11.002"},{"key":"bibr16-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1097\/FPC.0b013e32833ea085"},{"key":"bibr17-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0b013e318244a7fd"},{"key":"bibr18-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16002"},{"key":"bibr19-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-017-0553-2"},{"key":"bibr20-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13142"},{"key":"bibr21-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1111\/fcp.12328"},{"key":"bibr22-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2020.06.002"},{"key":"bibr23-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12798"},{"issue":"1","key":"bibr24-15269248221145044","first-page":"4","volume":"16","author":"Ucar AR","year":"2018","journal-title":"Exp Clin Transplant"},{"issue":"2","key":"bibr25-15269248221145044","first-page":"29","volume":"34","author":"Casati C","year":"2017","journal-title":"G Ital Nefrol"},{"key":"bibr26-15269248221145044","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-017-0549-9"}],"container-title":["Progress in Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15269248221145044","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15269248221145044","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15269248221145044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:41:54Z","timestamp":1777700514000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15269248221145044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,23]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1177\/15269248221145044"],"URL":"https:\/\/doi.org\/10.1177\/15269248221145044","relation":{},"ISSN":["1526-9248","2164-6708"],"issn-type":[{"value":"1526-9248","type":"print"},{"value":"2164-6708","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,23]]}}}