Korean J Transplant.  2022 Nov;36(Supple 1):S227. 10.4285/ATW2022.F-3635.

Risk of graft loss on once-daily versus twice-daily tacrolimus in kidney transplant patients: a meta-analysis

  • 1Department of Internal Medicine, Faculty of Medicine Udayana University, Denpasar, Indonesia


Tacrolimus has been used as immunosuppressant for various organ transplantation, including kidney. Recently, clinician is more interested in using once-daily tacrolimus compared to twice-daily due to higher adherence. One of main con-cern of kidney transplant is graft loss. Tacrolimus should be able to prevent graft loss in transplant patients. The primary objective of this study was to evaluate risk of graft loss of once-daily and twice-daily tacrolimus.
We systematically searched PubMed, Directory of Open Access Journal (DOAJ), and ScienceDirect screening with the following search terms: (kidney transplant OR renal transplant) AND (extended-release tacrolimus OR once-daily tacrolimus) AND (immediate-release tacrolimus OR twice-daily tacrolimus) AND (randomized controlled trial). We only included research articles fulfilling the following inclusion criteria: (1) studies enrolled adult patients (>18 years old) on tacrolimus after kidney transplantation, (2) studies studied graft failure as primary outcome.
Total seven studies were analyzed. We found that once-daily and twice-daily tacrolimus did not differ in risk of graft loss in kidney transplant patients (OR, 0.96 [0.65, 1.42]; P=0.84; I 2 : 0%, P=0.76).
Once-daily and twice-daily tacrolimus did not differ in risk of graft loss in kidney transplant patients.

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