Once-daily prolonged-release tacrolimus versus twice-daily tacrolimus in liver transplantation.

Journal Article


For patients who have received a kidney transplant, studies have shown that once-daily prolonged-release tacrolimus (TAC) has similar efficacy and safety to standard twice-daily dosing. The purpose of this study was to perform a meta-analysis to compare the effectiveness and safety of daily TAC (TAC qd) versus standard twice-daily TAC (TAC bid) administration in liver transplantation (LT).



Setting and participants

We systematically searched the PubMed/MEDLINE, Web of Science, and Cochrane Library databases for studies comparing outcomes of LT patients who received TAC qd versus TAC bid.

Outcome measures

Results were reported as odds ratios (ORs) with 95% CIs.


Six studies, which included 5179 LT recipients (TAC qd = 951; TAC bid = 4228) were included in the analysis. The TAC qd group had a low 1-year graft loss rate (OR 0.70 [95% CI 0.54-0.91], P = 0.008) and lower rate of biopsy-proven acute rejection (BPAR) at 90 days (OR 0.46 [95% CI 0.24-0.89], P = 0.02) compared with the TAC bid group. There was no significant difference in 1-year mortality or the incidence of adverse events after LT between the 2 groups.


Current evidence suggests that TAC qd is safe and effective for LT patients during the first year after transplantation. Longer-term follow-up studies are necessary to determine if TAC qd is safe and effective beyond the first year after LT.

Full Text

Duke Authors

Cited Authors

  • Huang, B; Liu, J; Li, J; Schroder, PM; Chen, M; Deng, R; Deng, S

Published Date

  • November 2019

Published In

Volume / Issue

  • 59 / 6

Start / End Page

  • 816 - 823.e2

PubMed ID

  • 31521585

Pubmed Central ID

  • 31521585

Electronic International Standard Serial Number (EISSN)

  • 1544-3450

International Standard Serial Number (ISSN)

  • 1544-3191

Digital Object Identifier (DOI)

  • 10.1016/j.japh.2019.08.002


  • eng