Background: A prolonged-release formulation of tacrolimus has been developed to provide once-daily dosing, with similar efficacy and safety to the standard twice-daily dosing and it may offer distinct advantages over an immediate-release action .We aimed to identify, appraise, and synthesize the current evidence comparing the efficacy and relative safety of the recently introduced daily versus standard twice-daily tacrolimus administration in liver transplantation.

Methods: We systematically searched for all randomized controlled trials and non-randomized controlled trials studies that compared the outcomes of daily versus twice-daily tacrolimus formulation in liver transplant recipients. Pubmed,web of science,cochane.Four trials were founded.Risk ratios and 95% confidence intervals (CI) were calculated to compare the combined data between groups that were treated with tacrolimus QD versus tacrolimus BID.

Results: Three randomized controlled trials (n=4967) and one non- randomized controlled trials (n=30) were included in our review. No significant differences were found between the two regimen in incidence of Biopsy-Proven Acute Rejection,renal failure, diabetes mellitus, one year graft survival, or one year patient survival. However,patients treated with a prolonged-release formulation of tacrolimus were more likely to get infected with a risk ratio of 1.27 (95% CI = 1.03–1.55)compared to the standard twice-daily dosing, and statistically significantly(P=0.02)

Conclusions: Once-daily tacrolimus dosing appears to be as effective as twice-daily tacrolimus dosing but has a more possibility of infection occurrence after liver transplantation.

CITATION INFORMATION: Deng R., Huang B., Shi Y., Ma Y. Once-Daily Prolonged-Release Tacrolimus versus Twice-Daily Tacrolimus in Liver Transplantation: A Meta-Analysis Am J Transplant. 2017;17 (suppl 3).

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