{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:17:14Z","timestamp":1777940234176,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Prog Transpl"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adverse effects from antimetabolites often lead to therapy adjustments; older patients may be more susceptible to these effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Project Aims<\/jats:title>\n                    <jats:p>Compare the intolerance of antimetabolites between older and younger lung transplant recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A single-center, retrospective analysis of adult lung transplant recipients transplanted between January 1, 2019 and October 31, 2021 was conducted. Patients were stratified by age at the time of transplant (\u226560 or &lt;60 years) and assessed for the first year posttransplant. The primary outcome was the incidence of antimetabolite intolerance (defined as dose adjustment, agent\/formulation change, or holding\/discontinuation of agent). Secondary outcomes included reason for intolerance, safety (infection and leukopenia), and efficacy (rejection and patient\/graft survival).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and nine recipients were included; 54 in the older (\u226560 years) and 55 in the younger (&lt;60 years) cohort. Most were initiated on azathioprine (74%) posttransplant. Antimetabolite intolerance occurred in 61% of older and 53% of younger recipients (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.377). The most common reasons for intolerance were leukopenia followed by gastrointestinal side effects. Biopsy-proven acute rejection occurred more often in the older cohort (39% vs 18%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017); this no longer remained significant when controlling for induction, indication, transplant type, gender, and antimetabolite intolerance (OR 0.36, 95% CI 0.11 to 1.15). There was no difference in the incidence of leukopenia, bacterial infection, or graft\/patient survival within 1 year posttransplant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Antimetabolite intolerance between older and younger lung transplant recipients was similar. Most required modification to the initial antimetabolite regimen due to leukopenia and gastrointestinal side effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15269248251327419","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T02:14:45Z","timestamp":1744596885000},"page":"110-116","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Antimetabolite Intolerance in Older Lung Transplant Recipients"],"prefix":"10.1177","volume":"35","author":[{"given":"Hansa","family":"Mreyoud","sequence":"first","affiliation":[{"name":"Department of Pharmacy, University of Michigan Health, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Michigan Health, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7961-494X","authenticated-orcid":false,"given":"Jeong M.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Michigan Health, Ann Arbor, MI, USA"},{"name":"College of Pharmacy, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6061-7387","authenticated-orcid":false,"given":"Elizabeth","family":"Wilpula","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Michigan Health, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Belloli","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Michigan Health, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1621-8031","authenticated-orcid":false,"given":"Krysta","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Michigan Health, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16991"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2020.100529"},{"issue":"1","key":"e_1_3_3_4_2","article-title":"Solid organ transplantation in older adults. Infectious and other age-related considerations","volume":"3","author":"Hemmersbach-Miller M","year":"2019","unstructured":"Hemmersbach-Miller M, Wolfe CR, Schmader KE. Solid organ transplantation in older adults. Infectious and other age-related considerations. OBM Transplant. 2019;3(1):1-19. doi:https:\/\/doi.org\/10.21926\/obm.transplant.1901046","journal-title":"OBM Transplant"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200106270-00012"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/nep.13718"},{"key":"e_1_3_3_7_2","unstructured":"Organ Procurement and Transplantation NetworkPolicy 10 Allocation of Lungs: 10.1.F Lung Disease Diagnosis Groups. Effective date December 5 2024; 241-246. Accessed December 5 2024. https:\/\/optn.transplant.hrsa.gov\/media\/eavh5bf3\/optn_policies.pdf."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14671"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-023-02699-5"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16795"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2023.08.001"}],"container-title":["Progress in Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15269248251327419","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15269248251327419","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15269248251327419","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:42:29Z","timestamp":1777700549000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15269248251327419"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,13]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1177\/15269248251327419"],"URL":"https:\/\/doi.org\/10.1177\/15269248251327419","relation":{},"ISSN":["1526-9248","2164-6708"],"issn-type":[{"value":"1526-9248","type":"print"},{"value":"2164-6708","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,13]]}}}