Parathyroid Allotransplant With a New Technique: A Prospective Clinical Trial

Exp Clin Transplant. 2016 Aug;14(4):431-5. doi: 10.6002/ect.2014.0294. Epub 2014 Sep 16.

Abstract

Objectives: Parathyroid allotransplant is a valuable alternative in treating permanent hypoparathyroidism. However, it is a difficult process that requires several trained staff and advanced laboratory equipment, which makes the costs high. Here, we identify a new parathyroid allotransplant technique.

Materials and methods: After obtaining informed consent from patients, parathyroid cell suspensions obtained from 4 donors who had undergone a subtotal parathyroidectomy owing to chronic renal failure were transplanted in 10 patients with permanent hypoparathyroidism after short-term cell cultivation. Prednisolone were used as immunosuppressant for the first 10 days and discontinued thereafter.

Results: Allograft function was observed in 7 patients (70%) at a mean follow-up of 12 months. Daily oral calcium and vitamin D supplementations discontinued totally in 7 patients. No major or minor complication was observed.

Conclusions: Our technique is simple, fast, and has a low cost, with a 70% success rate at a mean follow-up of 12 months. It requires few staff, minimal equipment, and short-term immunosuppressant use for maintenance. The technical developments of parathyroid allotransplant, as mentioned in this study, may be important in treating permanent hypoparathyroidism.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Allografts
  • Biomarkers / blood
  • Cell Transplantation / adverse effects
  • Cell Transplantation / methods*
  • Cells, Cultured
  • Drug Administration Schedule
  • Female
  • Glucocorticoids / administration & dosage
  • Graft Rejection / immunology
  • Graft Rejection / prevention & control
  • Graft Survival
  • Humans
  • Hypoparathyroidism / blood
  • Hypoparathyroidism / diagnosis
  • Hypoparathyroidism / etiology
  • Hypoparathyroidism / surgery*
  • Immunosuppressive Agents / administration & dosage
  • Middle Aged
  • Parathyroid Glands / immunology
  • Parathyroid Glands / metabolism
  • Parathyroid Glands / transplantation*
  • Parathyroid Hormone / blood
  • Parathyroidectomy / adverse effects*
  • Prednisolone / administration & dosage
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Turkey
  • Young Adult

Substances

  • Biomarkers
  • Glucocorticoids
  • Immunosuppressive Agents
  • PTH protein, human
  • Parathyroid Hormone
  • Prednisolone