Tacrolimus-Related Kidney Function Change in Ocular Stem Cell Transplantation

Area of Science:

• Ophthalmology
• Nephrology
• Immunology

Background:

• Ocular surface stem cell transplantation requires systemic immunosuppression.
• Tacrolimus is a common immunosuppressant, but its impact on kidney function needs evaluation.
• Maintaining therapeutic drug levels is crucial for efficacy and safety.

Purpose of the Study:

• To assess the effect of targeted tacrolimus trough blood levels on kidney function in patients post-ocular surface stem cell transplantation.
• To evaluate short-term and long-term renal outcomes, including acute kidney injury and chronic kidney disease.
• To determine the safety profile of tacrolimus in this patient population.

Main Methods:

• Retrospective chart review of 56 patients from January 2013 to December 2020.
• Primary outcome: acute kidney injury. Secondary outcomes: serum creatinine, glomerular filtration rate, and chronic kidney disease incidence.
• Tacrolimus trough levels were monitored, with dose adjustments made to maintain therapeutic ranges.

Main Results:

• Mean follow-up of 3.07 years.
• Serum creatinine transiently increased at 1-6 months, returning to baseline by 12 months.
• 5.4% experienced stage 1 acute kidney injury; 2 patients developed stage 3 chronic kidney disease. 85% required dose adjustments.

Conclusions:

• Systemic immunosuppression with tacrolimus is well-tolerated after ocular surface stem cell transplantation.
• Tacrolimus contributes to high graft survival rates.
• Minimal impact on acute and long-term kidney function was observed.