CURATE.AI-Artificial Intelligence-Derived Personalized Tacrolimus Dosing for Pediatric Liver Transplant: A Retrospective Study

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. Tacrolimus is the cornerstone of immunosuppressive therapy after pediatric liver transplantation. This study develops CURATE.AI, a small-data artificial intelligence-derived platform, as a clinical decision support system to dynamically personalize tacrolimus doses using the patient's own data. Retrospective dose personalization with CURATE.AI demonstrates the potential to enable more patients to reach the therapeutic range within the first week.image