https://www.ncbi.nlm.nih.gov/pubmed/30719833 liver transplant
Pediatr Transplant. 2019 Feb 4:e13368. doi: 10.1111/petr.13368. [Epub ahead of print]
Early post-operative intravenous tacrolimus in pediatric liver transplant recipients is not superior to oral tacrolimus.
Sabra TA1,2,3, Okajima H1, Yoshizawa A1, Ogawa E1, Okamoto S1, Osman MA2, Saad-Eldin Y4, Uemoto S1.
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Abstract
We aimed to compare the early results of i.v. with p.o. TAC as a primary immunosuppressant in pediatric patients undergoing LT. This retrospective study enrolled 75 children who underwent LT and received TAC-steroid regimens as a primary immunosuppressant between September 2011 and October 2015 at our institution. Thirty-five recipients received TAC i.v. and 40 received TAC p.o. Early results were evaluated and compared, including ACR, EBV, or CMV infection; renal adverse effects; and hospital stay. Comparisons of 90-day post-transplant results showed that the rates of overall viral (74% vs 40% P < 0.002), EBV (46% vs 17.5% P < 0.008), and CMV (51% vs 30% P = 0.05) infections were significantly higher in the i.v. than in the p.o. group. Neither regimen has any adverse effects on renal function. There were no between-group differences in ACR incidence and severity, serum creatinine concentration, and hospital stay. Patient and graft survival rates at 3 months and 1 year did not differ significantly between the two groups. Compared with p.o. treatment, i.v. administration of high TAC concentration did not have beneficial post-transplant effects on ACR incidence and severity, while increasing the incidence of viral infections in pediatric LT.