Tacrolimus-Related Kidney Function Change in Ocular Stem Cell Transplantation

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PURPOSE: This study evaluated the impact of maintaining appropriate trough blood levels of tacrolimus on kidney function in patients undergoing systemic immunosuppression after ocular surface stem cell transplantation. METHODS: A retrospective chart review of 56 patients was performed between January 2013 and December 2020. The primary outcome in this study was acute kidney injury. Secondary outcomes included evaluating serum creatinine at 1, 3, 6, and 12 months; glomerular filtration rate at 1, 2, 3, 4, and 5 years; and the incidence of stage 3 or greater chronic kidney disease. RESULTS: The impact of tacrolimus on kidney function was evaluated in 56 patients over a mean follow-up of 3.07 years (range: 0.56-7.23). For the cohort, the mean serum creatinine increased significantly at 1, 3, and 6 months but then returned to baseline by 12 months. Three patients (5.4%) experienced stage 1 acute kidney injury, with two patients progressing to stage 3 chronic kidney disease. Tacrolimus trough levels were closely monitored, with dose adjustments required for 85% of patients within the first year to maintain therapeutic levels. CONCLUSIONS: Systemic immunosuppressive therapy with tacrolimus after ocular surface stem cell transplantation is well tolerated and contributes to high graft survival rates with minimal impact on acute and long-term kidney function.

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