{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:20:20Z","timestamp":1787768420145,"version":"build-2784847793"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"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":["Breastfeeding Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Improving survival after liver transplantation has increased pregnancy rates among women of reproductive age, raising critical questions about breastfeeding safety with maintenance immunosuppressants. Quantitative human data on everolimus transfer into breast milk remain extremely limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Pharmacokinetic assessment of everolimus (0.25 mg\/day once daily) was performed in a woman postpartum day 5 after cesarean delivery. Maternal whole-blood and breast milk samples were collected under steady-state conditions. Whole-blood concentrations were measured by automated immunoassay; breast milk concentrations were quantified by liquid chromatography\u2013tandem mass spectrometry (LC\u2013MS\/MS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Maternal whole-blood concentrations peaked at 4 hours (1.98 ng\/mL). Breast milk concentrations showed a delayed peak at 9 hours (0.117 ng\/mL). Using the linear trapezoidal method, the milk-to-whole-blood AUC0-24 ratio was 0.078, and the estimated relative infant dose (RID) was 0.30%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This first liver transplant case demonstrates minimal transfer of everolimus into breast milk, with an estimated RID of 0.30% and delayed mammary peak kinetics. High-sensitivity LC-MS\/MS enabled reliable quantification even at minimal maternal doses. Although limited to a single case, these findings provide clinically relevant human pharmacokinetic data to support individualized breastfeeding counseling in everolimus-treated liver transplant recipients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253261483396","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T06:05:26Z","timestamp":1787551526000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Everolimus Breast Milk Transfer After Liver Transplantation"],"prefix":"10.1177","author":[{"given":"Nozomi","family":"Yoshimoto","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hinata","family":"Ueda","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmaceutics &amp; Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmaceutics &amp; Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuya","family":"Narumi","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmaceutics &amp; Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmaceutics &amp; Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Matsuzawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayo","family":"Tomimori","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michika","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Miyazaki Hospital, Miyazaki, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuji","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Miyazaki Hospital, Miyazaki, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1609-1995","authenticated-orcid":false,"given":"Shinji","family":"Katsuragi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03656.x"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000252683.74584.29"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02980707"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199708270-00002"},{"key":"e_1_3_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2019.07.001"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200443020-00002"},{"key":"e_1_3_5_8_1","unstructured":"7.Novartis Pharmaceuticals Corporation. Afinitor (everolimus). Novartis Pharmaceuticals Corporation: East Hanover NJ; 2023."},{"key":"e_1_3_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01024-7"},{"key":"e_1_3_5_10_1","doi-asserted-by":"publisher","DOI":"10.12659\/AOT.907944"},{"key":"e_1_3_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000001009"},{"key":"e_1_3_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchromb.2024.124100"},{"key":"e_1_3_5_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200404000-00023"},{"key":"e_1_3_5_14_1","volume-title":"Medications and Mothers\u2019 Milk","author":"Hale TW","year":"2023","unstructured":"13.Hale TW, , Rowe HE. Medications and Mothers\u2019 Milk, 20th ed. Springer Publishing Company: New York, NY; 2023.","edition":"20"},{"key":"e_1_3_5_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2018.1476492"},{"key":"e_1_3_5_16_1","volume-title":"Everolimus. Drugs and Lactation Database (LactMed\u00ae)","author":"National Library of Medicine (US)","year":"2025","unstructured":"15.National Library of Medicine (US). Everolimus. Drugs and Lactation Database (LactMed\u00ae). National Library of Medicine: Bethesda, MD; 2025."},{"key":"e_1_3_5_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/pediatric13010015"},{"key":"e_1_3_5_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2014.00065"},{"key":"e_1_3_5_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2015.08.003"},{"key":"e_1_3_5_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10928-020-09711-2"},{"key":"e_1_3_5_21_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1A384"},{"key":"e_1_3_5_22_1","doi-asserted-by":"publisher","DOI":"10.1208\/s12248-019-0316-z"},{"key":"e_1_3_5_23_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06400612"},{"key":"e_1_3_5_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000066352.86763.D0"},{"key":"e_1_3_5_25_1","volume-title":"Fact sheet","author":"World Health Organization","year":"2023","unstructured":"24.World Health Organization. Infant and young child feeding. In: Fact sheet. WHO: Geneva; 2023. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/infant-and-young-child-feeding"},{"key":"e_1_3_5_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2020.05.007"}],"container-title":["Breastfeeding Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15568253261483396","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15568253261483396","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15568253261483396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:47:52Z","timestamp":1787766472000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15568253261483396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,23]]},"references-count":25,"alternative-id":["10.1177\/15568253261483396"],"URL":"https:\/\/doi.org\/10.1177\/15568253261483396","relation":{},"ISSN":["1556-8253","1556-8342"],"issn-type":[{"value":"1556-8253","type":"print"},{"value":"1556-8342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,23]]},"article-number":"15568253261483396"}}