{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:56:34Z","timestamp":1792684594780,"version":"4.5.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aimed to develop a limited sampling strategy (LSS) and predictive equations to accurately estimate the areas under the concentration-time curves (AUC) of extended-release tacrolimus (TAC-ER) and mycophenolic acid (MPA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of Japanese kidney transplant recipients yielded 90 TAC-ER AUC0-24 (23 patients) and 80 MPA AUC0-12 (29 patients) datasets, which were randomly split into learning and validation datasets. Training datasets were used to generate the LSS model equations based on multiple linear regression analysis, and the coefficient of determination (R2) was used to assess the goodness of fit of regression models. Validation datasets applied the selected training equations to compute error indices, Passing-Bablok\u2019s Kendall\u2019s \u03c4, and Bland\u2013Altman limits of agreement, thereby assessing predictive bias, accuracy, and precision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and discussion<\/jats:title>\n                    <jats:p>Four equations (C0-C1-C6, C0-C1-C2-C6, C0-C1-C3-C6, C0-C1-C4-C6) showed strong correlations with the actual AUC (R\u00b2 &amp;gt; 0.95), with the validation identifying C0-C1-C3-C6 as the most reliable for both TAC-ER and MPA. This study demonstrated that LSS using C0-C1-C3-C6 reliably and accurately estimated both the actual TAC-ER AUC0-24 and MPA AUC0-12 simultaneously in kidney transplant recipients. These equations can be feasibly implemented in outpatient clinical settings to reduce time and cost.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1710261","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T05:22:27Z","timestamp":1770096147000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Establishment of accurate estimation equations for area under the concentration curves using simultaneous limited sampling for extended-release tacrolimus and mycophenolic acid in kidney transplant recipients"],"prefix":"10.3389","volume":"17","author":[{"given":"Kyoko","family":"Minamisono","sequence":"first","affiliation":[{"name":"Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University","place":["Shimotsuke, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshimasa","family":"Nakao","sequence":"additional","affiliation":[{"name":"Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University","place":["Shimotsuke, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Ohyama","sequence":"additional","affiliation":[{"name":"Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University","place":["Shimotsuke, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sho","family":"Nishida","sequence":"additional","affiliation":[{"name":"Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University","place":["Shimotsuke, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplant Surgery, Sapporo City General Hospital","place":["Sapporo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Hirose","sequence":"additional","affiliation":[{"name":"Department of Renal and Genitourinary surgery, Faculty of Medicine, Hokkaido University","place":["Sapporo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohiko","family":"Hotta","sequence":"additional","affiliation":[{"name":"Department of Renal and Genitourinary surgery, Faculty of Medicine, Hokkaido University","place":["Sapporo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makiko","family":"Mieno","sequence":"additional","affiliation":[{"name":"Division of Center for Information, Jichi Medical University","place":["Shimotsuke, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiki","family":"Iwami","sequence":"additional","affiliation":[{"name":"Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University","place":["Shimotsuke, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2174\/1389200219666180129151948","article-title":"Pharmacokinetics, Pharmacodynamics and Pharmacogenetics of Tacrolimus in Kidney Transplantation","volume":"19","author":"Yu","year":"2018","journal-title":"Curr Drug Metab"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2174\/1381612826666200521142448","article-title":"Immunosuppression in Kidney Transplantation: State of the Art and Current Protocols","volume":"26","author":"Bauer","year":"2020","journal-title":"Curr Pharm Des"},{"key":"B3","doi-asserted-by":"publisher","first-page":"101757","DOI":"10.1016\/j.bpg.2021.101757","article-title":"Immunosuppressive drugs modes of action","author":"Meneghini","year":"2021","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(00)70013-8","article-title":"Abbreviated tacrolimus area-under-the-curve monitoring for renal transplant recipients","volume":"35","author":"Wong","year":"2000","journal-title":"Am J Kidney Dis"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(02)03684-9","article-title":"The roles of C4 and AUC0\u20134 in monitoring of tacrolimus in stable kidney transplant patients","volume":"34","author":"Pisitkun","year":"2002","journal-title":"Transplant Proc"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2004.00041.x","article-title":"Immunosuppressive drug monitoring - 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