ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2017
The Medication Level Variability Index (MLVI) Predicts Poor Liver Transplant Outcomes: A Prospective Multi-Site Study.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01154075 (Medication Adherence in Children Who Had a Liver Transplant), which is not on this map. Cited by 63 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Medication Adherence in Children Who Had a Liver Transplant
Who cites it
63 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of immunosuppressant adherence interventions in transplant recipients: Decoding the streetlight effect.Pediatric transplantation · 2018Pooled it
- A remote intervention to improve medication nonadherence guided by a marker of risk derived from the electronic health records of adolescent transplant recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Trial
- Health advocates to address social adversity in pediatric liver transplantation: A clinical trial.Hepatology communications · 2026Trial
- A multi-centre randomised control trial of directly observed therapy to promote medication adherence in paediatric heart transplant recipients.Cardiology in the young · 2024Trial
- Randomized pilot trial of praise text messages to improve medication adherence among adolescents and young adults with liver transplants.Pediatric transplantation · 2022Trial
- Remote intervention engagement and outcomes in the Clinical Trials in Organ Transplantation in Children consortium multisite trial.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Trial
- Self-Management Measurement and Prediction of Clinical Outcomes in Pediatric Transplant.The Journal of pediatrics · 2018Trial
- Review
- Psychosocial challenges faced by children who had a solid organ transplant: adherence, transition, and posttraumatic stress.Current opinion in organ transplantation · 2026Review
- Growth Trajectories of Medication Adherence in Pediatric Organ Transplantation and Their Relationship to Posttransplant Health Outcomes.Transplantation direct · 2026Article
- Defining the Society of Pediatric Liver Transplantation (SPLIT) research agenda: A Delphi consensus project.Hepatology communications · 2026Article
- Neighborhood Deprivation Linked to Medication Level Variability in Liver Transplant Recipients.Clinical transplantation · 2025Article
- Transition from pediatric to adult care in thoracic transplantation-Challenges and opportunities.JHLT open · 2025Article
- Material economic hardships are associated with adverse 1-year outcomes after pediatric liver transplantation: Prospective cohort results from the multicenter SOCIAL-Tx Study.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Observational
- Tacrolimus IPV Group Membership Does Not Consistently Track With Electronically Monitored or Self-reported Adherence in Adolescent and Young Adult Kidney Transplant Recipients.Transplantation direct · 2025Article
- Inter-Dose Variability of Immunosuppressant Medication Among Adolescent Heart Transplants During Video Directly Observed Therapy.Pediatric transplantation · 2025Article
- Oral medication adherence predicts cyclosporine blood level variability and graft versus host disease following pediatric allogeneic hematopoietic stem cell transplant.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025Article
- Immunosuppressant adherence after heart transplantation: a review on detection, prevention, and intervention strategies in a multidisciplinary.Frontiers in cardiovascular medicine · 2025Review
- SELF-REPORTED QUALITY OF LIFE, IMPULSIVITY AND NON-ADHERENCE TO IMMUNOSUPPRESSIVE MEDICATION AFTER LIVER TRANSPLANTATION: A COHORT STUDY.Arquivos de gastroenterologia · 2025Article
- Intrapatient tacrolimus variability is associated with medical nonadherence among pediatric kidney transplant recipients.Frontiers in transplantation · 2025Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Nonadherence to immunosuppressant medications is a leading cause of poor long-term outcomes in transplant recipients. The Medication Level Variability Index (MLVI) provides a vehicle for transplant outcome risk-stratification through continuous assessment of adherence. The MALT (Medication Adherence in children who had a Liver Transplant) prospective multi-site study evaluated whether MLVI predicts late acute rejection (LAR). Four hundred pediatric (1-17-year-old) liver transplant recipients were enrolled and followed for 2 years. The a-priori hypothesis was that a higher MLVI predicts LAR. Predefined secondary analyses evaluated other outcomes such as liver enzyme levels, and sensitivity analyses compared adolescents to pre-adolescents. In the primary analysis sample of 379 participants, a higher prerejection MLVI predicted LAR (mean prerejection MLVI with LAR: 2.4 [3.6 standard deviation] versus without LAR, 1.6 [1.1]; p = 0.026). Fifty-three percent of the adolescents with MLVI>2 in year 1 had LAR by the end of year 2, as compared with 6% of those with year 1 MLVI≤2. A higher MLVI was significantly associated with all secondary outcomes. MLVI, a marker of medication adherence that uses clinically derived information, predicts LAR in pediatric liver transplant recipients.
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