title: Tacrolimus effects and side effects after liver transplantation: is there a difference between immediate and extended release?
abstract: BACKGROUND
  Immunosuppressive therapy after orthotopic liver transplantation (OLT) requires a high degree of patient compliance to guarantee safety and avoid side effects. In 2007, prolonged-release tacrolimus was launched in Europe to improve compliance. In this prospective observational crossover single-center trial, we analyzed effects and side effects of prolonged-release tacrolimus in OLT patients.
  
  
  METHODS
  LT patients at our center were included if they were older than l8 years of age, had had the procedure at least 6 months prior, and were outpatients currently on twice-daily tacrolimus. Patients were observed for 6 months before switching to once-daily tacrolimus. Patient history, clinical examination, and laboratory examinations were recorded on inclusion as well as after 3, 6, 9, 12, and 18 months.
  
  
  RESULTS
  The rates of rejection, hypertension, hypercholesterolemia, and diabetes mellitus were compared during twice-daily and once-daily tacrolimus. Similarly, laboratory parameters were identical during both periods with the exception of glycated hemoglobin, which was significantly elevated under once-daily tacrolimus (P = .00l).
  
  
  CONCLUSIONS
  Converting patients to extended-release tacrolimus with was safe in terms of rejection, hypertension, and hypercholesterolemia as well as renal and liver functions. Further investigations concerning pharmacokinetics and glucose metabolism will be needed to evaluate prolonged-release tacrolimus.
authors: Department of Transplantation, Hepatobiliary and Pancreatic Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany. nina.weiler@unimedizin-mainz.de
authors: N
authors: N
authors: Weiler
authors: I
authors: I
authors: Thrun
authors: M
authors: M
authors: Eberlin
authors: D
authors: D
authors: Foltys
authors: M
authors: M
authors: Heise
authors: M
authors: M
authors: Hoppe-Lotichius
authors: T
authors: T
authors: Zimmermann
authors: I
authors: I
authors: Kraemer
authors: G
authors: G
authors: Otto
mesh_terms: D000328:Adult; D000368:Aged; D002626:Chemistry, Pharmaceutical; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D005260:Female; D005858:Germany; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003692:Delayed-Action Preparations; D007166:Immunosuppressive Agents; D016559:Tacrolimus