Tacrolimus is the cornerstone of immunosuppressive therapy after pediatric liver transplantation. However, reliance on the physician's experience for dose titration, coupled with tacrolimus's narrow therapeutic window and inter- and intrapatient variability, often results in frequent under or overdosing events with detrimental patient outcomes. Existing predictive dose personalization models are not readily feasible for clinical implementation, as they require multiple measurements each day while the standard frequency is once daily. CURATE.AI, a small-data artificial intelligence-derived platform, is developed as a clinical decision support system to dynamically personalize doses using the patient's own data obtained once a day. Retrospective dose personalization with CURATE.AI on 16 patients’ data demonstrates potential to enable more patients to reach therapeutic range within the first week. The findings support the testing of CURATE.AI in a prospective controlled trial as an aid for the physician's decision on tacrolimus dose personalization after pediatric liver transplantation.

中文翻译：

---

CURATE.AI——人工智能衍生的小儿肝移植个性化他克莫司剂量：一项回顾性研究

他克莫司是小儿肝移植后免疫抑制治疗的基石。然而，依赖医生的剂量滴定经验，加上他克莫司的狭窄治疗窗以及患者间和患者内的变异性，常常导致频繁的剂量不足或过量事件，从而对患者产生不利的结果。现有的预测剂量个性化模型不太适合临床实施，因为它们需要每天多次测量，而标准频率是每天一次。 CURATE.AI 是一个小数据人工智能衍生平台，被开发为临床决策支持系统，可使用每天一次获得的患者自己的数据动态个性化剂量。使用 CURATE.AI 对 16 名患者的数据进行的回顾性剂量个性化表明，有可能使更多患者在第一周内达到治疗范围。这些发现支持在一项前瞻性对照试验中对 CURATE.AI 进行测试，以帮助医生在小儿肝移植后做出他克莫司剂量个性化的决定。