RESUMO
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.
Assuntos
Transplante de Células/métodos , Hipoparatireoidismo/cirurgia , Glândulas Paratireoides/transplante , Paratireoidectomia/efeitos adversos , Adulto , Aloenxertos , Biomarcadores/sangue , Transplante de Células/efeitos adversos , Células Cultivadas , Esquema de Medicação , Feminino , Glucocorticoides/administração & dosagem , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto , Humanos , Hipoparatireoidismo/sangue , Hipoparatireoidismo/diagnóstico , Hipoparatireoidismo/etiologia , Imunossupressores/administração & dosagem , Pessoa de Meia-Idade , Glândulas Paratireoides/imunologia , Glândulas Paratireoides/metabolismo , Hormônio Paratireóideo/sangue , Prednisolona/administração & dosagem , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Turquia , Adulto JovemRESUMO
OBJECTIVES: To develop a new parathyroid allotransplant method for the treatment of permanent hypoparathyroidism. MATERIALS AND METHODS: Parathyroid cells 50 × 10(6) derived from a parathyroid hyperplasia patient were transferred to a 61-year-old patient who had thyroidectomy 17 years earlier, allowing to papillary thyroid cancer; he was admitted to our outpatient clinic with symptomatic chronic hypocalcemia. Cell isolation, cryopreservation, and culturing were conducted according to a new protocol. RESULTS: During a follow-up of 5 months, the patient had no complications that could indicate rejection, and clinical symptoms completely resolved without requiring any drug supplementation. CONCLUSIONS: Here, we report a new method, enabling fast and cost-effective parathyroid allotransplant with maintained tissue viability sufficient to treat persistent hypocalcemia.
