A novel non‐surgical, minimally invasive technique for parathyroid autotransplantation: A case report

Abstract

We present a case report of intramuscular autotransplantation of the parathyroid cell suspension acquired after total parathyroidectomy. A 15-yr-old female patient who had been undergoing hemodialysis due to chronic renal failure for eight yr was diagnosed with secondary hyperthyroidism and subsequently underwent total parathyroidectomy. The parathyroid cells were acquired from the resected tissues, processed through isolation and cultivation phases, and counted using a cell counter. A total of two million cells were injected into the left deltoid muscle using a 22-gauge needle. After surgery, five and 10 million cells were injected in the fifth and 12 week, respectively. The desired serum levels of parathyroid hormones and calcium were not achieved after the first two transplantations. In addition, there was no regression in the patient's symptoms. However, at four wk after the third transplantation, serum parathyroid hormone level did not decrease to <3 pg/mL, the patient was asymptomatic, and the oral treatment was stopped. Our findings indicate that this new technique is applicable because it is minimally invasive, and it can be easily repeated.

Fresh tissue parathyroid allotransplantation with short‐term immunosuppression: 1‐year follow‐up

“…Microencapsulation technique is another suitable method for avoiding an immune response because of capsule formation, but costs are relatively high. We have evaluated all of this information not only from the literature, but also from our experience from previous studies …”

“…We have evaluated all of this information not only from the literature, but also from our experience from previous studies. 11,12,15,16 Fresh tissue transplantation is a promising tissue type for the PA technique which was described almost three decades ago by Zeng et al 17 However, it has not been widely implemented. In 1991, Kunori et al 18 used the same method for treatment for an 18-year-old male who had severe PH due to elective thyroid surgery.…”

Untitled

“…In these case reports, during follow-up, patients had no complications that could indicate rejection, and clinical symptoms completely resolved with no drug supplementation. 24,25 In this study, we presented this hybrid system that covers the advantages of either the clinical or laboratory aspects of parathyroid allotransplant for a 10 patient's series. With the exception of 10 days of short-term immunosuppressant use (via 3-day parenteral and 7-day oral routes) in the clinical aspect and short-term cell cultivation, in addition to the standard cell isolation procedures in the laboratory, we did not perform any additional process that requires additional cost, equipment, or staff.…”

Parathyroid allotransplantation for severe post-surgical hypoparathyroidism: a Brazilian experience

“…The preparation of fresh graft tissue is easy, and the implantation can be performed immediately. Encapsulated and cultured cells are costly and require additional equipment and well-trained staff [32]. Although Case 2 developed local ecchymosis, it was spontaneously absorbed.…”