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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 main tenance. The technical developments of parathyroid allotransplant, as mentioned in this study, may be important in treating permanent hypoparathyroidism.

Patients’ views about parathyroid transplantation for post-thyroidectomy hypoparathyroidism

“…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 and no complications were observed [ 23 ].…”

Hypoparathyroidism: State of the Art on Cell and Tissue Therapies

“…As immunosuppressive therapy, prednisolone was administered from five days to 1 month (depending on the study) and then stopped. In both of their studies, Aysan and colleagues [67,68] reported no side effects and a success rate of 70% at a mean follow-up of 12 months.…”

“…It was discovered that the biggest part of the parathyroid tissue presents the Human Leucocyte Antigen (HLA) class I only slightly expressed, so parathyroid cells may not be involved in transplant rejection. It has been possible to develop a long-running allograft that excludes the cells that express HLA class II antigens (i.e., lymphocytes, macrophages and granulocytes) from the insertion into the recipient [22,32,67,68].…”

“…In this case, they did not see any complications during the follow-up period, demonstrating that a fresh-tissue parathyroid transplantation associated with a short-term immunosuppression therapy could represent a promising technique, easy to perform, and with a low risk of side effects and minimal complications with compatibility for the HLA condition. Another type of parathyroid gland transplantation is the allotransplantation of cryopreserved parathyroid tissue [67][68][69][70][71][72][73].…”

“…In relation to the development of new parathyroid allotransplantation methods, Aysan and colleagues [67,68] described a new parathyroid allotransplant method which has been described in several other studies [74][75][76][77][78][79][80]. This new method is based on the separation of the collected donor parathyroid tissue from the surrounding blood vessels, gland capsule, connective, and fatty tissue through a sterile filtration, followed by a mechanical fragmentation of the isolated tissue in 1X DPBS solution supplemented with 5% inactivated fetal bovine serum.…”