BACKGROUND: We compared, through the European Liver Transplant Registry, long-term liver transplantation outcomes with prolonged-release tacrolimus (PR-T) versus immediate-release tacrolimus (IR-T)-based immunosuppression. This retrospective analysis comprises up to 8-year data collected between 2008 and 2016, in an extension of our previously published study. METHODS: Patients with <1 month follow-up were excluded; patients were propensity score matched for baseline characteristics. Efficacy measures included: univariate/multivariate analyses of risk factors influencing graft/patient survival up to 8 years posttransplantation, and graft/patient survival up to 4 years with PR-T versus IR-T. Overall, 13 088 patients were included from 44 European centers; propensity score-matched analyses comprised 3006 patients (PR-T: n = 1002; IR-T: n = 2004). RESULTS: In multivariate analyses, IR-T-based immunosuppression was associated with reduced graft survival (risk ratio, 1.49; P = 0.0038) and patient survival (risk ratio, 1.40; P = 0.0215). There was improvement with PR-T versus IR-T in graft survival (83% versus 77% at 4 y, respectively; P = 0.005) and patient survival (85% versus 80%; P = 0.017). Patients converted from IR-T to PR-T after 1 month had a higher graft survival rate than patients receiving IR-T at last follow-up (P < 0.001), or started and maintained on PR-T (P = 0.019). One graft loss in 4 years was avoided for every 14.3 patients treated with PR-T versus IR-T. CONCLUSIONS: PR-T-based immunosuppression might improve long-term outcomes in liver transplant recipients than IR-T-based immunosuppression.

Abdominal Transplant Surgery University Hospital Leuven Leuven Belgium

Center of Cardiovascular Surgery and Transplantation Brno Czech Republic

Department for Gastroentrology Nephrology and Surgery Vilnius University Hospital Santaros Klinikos Vilnius Lithuania

Department for Surgery and Transplantation University Hospital Copenhagen Copenhagen Denmark

Department of Digestive Surgery AP HP Beaujon Hospital Clichy France

Department of Digestive Surgery Archet 2 Hospital Nice France

Department of General and Transplant Surgery University Hospital Essen Essen Germany

Department of General and Visceral Surgery Goethe University Hospital and Clinics Frankfurt Germany

Department of General Hepato Biliary and Liver Transplantation Surgery Ghent University Hospital Medical School Belgium

Department of General Surgery and Transplantation Hospital G Brotzu Cagliari Italy

Department of General Surgery Organ Transplant Unit Paride Stefanini Umberto 1 Policlinico of Rome Rome Italy

Department of General Transplant and Liver Surgery Medical University of Warsaw Warsaw Poland

Department of General Visceral and Pediatric Surgery University Medical Center Göttingen Göttingen Germany

Department of General Visceral and Transplantation Surgery Charité Campus Virchow Klinikum Berlin Germany

Department of General Visceral and Transplantation Surgery Hannover Medical School Hannover Germany

Department of Hepatology and Gastroenterology University Hospital of Henri Mondor Creteil France

Department of Surgery and Liver Transplantation Fundeni Clinical Institute University of Medicine Carol Davila Bucharest Romania

Department of Surgery Hospital Hautepierre University Hospitals of Strasbourg Strasbourg France

Department of Surgery Liver Transplant Unit University Hospital Udine Udine Italy

Department of Surgery Pope John XXIII Hospital Bergamo Italy

Department of Transplantation Medicine Oslo University Hospital Oslo Norway

Department of Transplantation Surgery Karolinska University Hospital Huddinge Sweden

Department of Visceral and Transplant Surgery University Hospital Zurich Zurich Switzerland

Department of Visceral Surgery University Hospital Besançon University of Franche Comté Besançon France

Department of Visceral Surgery University Hospital Rennes Pontchaillou Hospital Rennes France

Department of Visceral Transplant and Thoracic Surgery Innsbruck Medical University Innsbruck Austria

General Visceral and Transplantation Surgery Clinic Johannes Gutenberg University Mainz Mainz Germany

Hepato Biliary Center AP HP Paul Brousse Hospital University of Paris Sud INSERM U935 Villejuif France

Hepato Pancreato Biliary Surgery and Liver Transplantation Unit University of Modena and Reggio Emilia Modena Italy

Hepatobiliary and Abdominal Transplantation Surgery Department of Experimental and Clinical Medicine Polytechnic University of Marche Ancona Italy

Hepatobiliary Surgery and Liver Transplantation Unit University of Pisa Medical School Hospital Pisa Italy

Kent Hospital Izmir Turkey

Liver Transplant Unit Tor Vergata Polyclinic University of Rome Tor Vergata Rome Italy

Liver Transplantation Unit University of Edinburgh Royal Infirmary Edinburgh United Kingdom

Liver Unit King's College Hospital London United Kingdom

Liver Unit St Vincent's Hospital Dublin Ireland

Mediterranean Institute for Transplantation and Advanced Specialized Therapies Palermo Sicily Italy

Republican Scientific and Practical Center for Organ and Tissue Transplantation Minsk Belarus

St James and Seacroft University Hospital Leeds United Kingdom

Surgery and Organ Transplantation Center Central Hospital of Oil Workers Baku Azerbaijan

Surgery Clinic Tartu University Hospital Tartu Estonia

Surgery Department Transplantation and Liver Surgery Unit Sahlgrenska University Hospital Gothenburg Sweden

Surgical Clinic and Polyclinic University Hospital Klinikum rechts der Isar Munich Munich Germany

Transplant Center Institute for Clinical and Experimental Medicine Prague Czech Republic

University of Bologna Transplant and HPB Institute Bologna Italy

Citace poskytuje Crossref.org

Long-term, Prolonged-release Tacrolimus-based Immunosuppression in De Novo Liver Transplant Recipients: 5-year Prospective Follow-up of Patients in the DIAMOND Study