{"doi":"10.1177/09636897241309412","title":"Impact of Tacrolimus, Sirolimus, Age, and Body Mass Index on the Occurrence of Skin Cancer and Islet Dysfunction After Transplantation","abstract":"Herein, we characterized the percentage of tacrolimus to the combined sirolimus and tacrolimus trough levels (tacrolimus %) observed during islet transplant-associated immune suppression therapy with post-transplant skin cancer. Although trough levels of tacrolimus and sirolimus were not different ( P = 0.79, 0.73, respectively), high tacrolimus % resulted in a 1.32-fold increase in skin cancer odds when adjusting for age, sex, body mass index (BMI), and use of mycopheonlate mofetil (MMF; p = 0.039). Skin cancer patients were likely to have been older but not differ significantly (mean difference 12 years, P = 0.056), but age was significantly associated with a 1.22-fold increase in adjusted skin cancer odds ( P = 0.046). BMI was inversely associated with skin cancer, with an adjusted odds ratio (OR) of 0.40 ( P = 0.022). High tacrolimus % (>35) resulted in a 4.6-fold increase in skin cancer frequency, whereas sirolimus above 75% of the combined therapy led to a 5.2-fold increase in islet graft dysfunction (IGD) events/year. By calculating the maximum safe exposure (MSE) to tacrolimus % according to patient age and BMI, we found that cumulative months spent above MSE was predictive of skin cancer (1.20-fold increase, P = 0.003). Individuals exceeding the MSE for 1 year were 9.2 times more likely to develop skin cancer ( P = 0.008). Results suggest that strategies targeting immunosuppression ratios based on age and BMI may minimize cancer risk while improving graft survival and function.","journal":"Cell Transplantation","year":2025,"id":538436,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9525,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1425404,"name":"Jeannette Stratton","orcid":null,"position":1,"is_corresponding":false},{"id":1425405,"name":"Mohamed A. El-Shahawy","orcid":null,"position":2,"is_corresponding":false},{"id":1425406,"name":"Elena Forouhar","orcid":null,"position":3,"is_corresponding":false},{"id":1048823,"name":"Alice Peng","orcid":"0000-0003-1877-2001","position":4,"is_corresponding":false},{"id":420348,"name":"Gagandeep Singh","orcid":"0000-0002-4743-4696","position":5,"is_corresponding":false},{"id":743285,"name":"Keiko Omori","orcid":"0000-0002-4200-8460","position":6,"is_corresponding":false},{"id":743284,"name":"Meirigeng Qi","orcid":"0000-0002-8531-8733","position":7,"is_corresponding":false},{"id":351268,"name":"Fouad Kandeel","orcid":"0000-0003-3746-5015","position":8,"is_corresponding":false},{"id":1140569,"name":"Chris Orr","orcid":"0000-0001-9123-5101","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T02:52:21.389196Z","pmid":"39780302","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}