TITLE:
Experience with Post Transplant Parathyroidectomy in Gulf Region and Literature Review
AUTHORS:
Samra Abouchacra, Ahmed Chaaban, Ammar Abdel Baki, Khalid Al Mashari, Saif Al Sobhi, Atia Al Zahrani, Qutaiba Hussain, Nicole Gebran, Mohamed Ahmed, Imran Khan, Bassam Bernieh, Mohammad Budruddin
KEYWORDS:
Parathyroidectomy; Renal Transplantation; Parathyroid Hormone; Hyperparathyroidism
JOURNAL NAME:
Open Journal of Nephrology,
Vol.3 No.4,
December
27,
2013
ABSTRACT: Sustained elevation of parathyroid hormone (PTH) levels
is not uncommon post renal transplantation. Though in the majority of patients,
it gradually normalizes, on average 5% of transplanted patients require
parathyroidectomy (PTX). However, PTX itself has been associated with
deterioration in allograft function and even completes graft loss seen
with both total and subtotal PTX as well as an increased rate of acute
rejection. The aim of this study was to determine the effect of post transplant
partial PTX on allograft function in our patients as well as the incidence of
acute rejection. Our results show that post transplantation, subtotal PTX, was
successful in achieving metabolic control while preserving graft function
without an increased incidence of acute rejection. Retention of sufficient
residual parathyroid tissue with partial PTX might account for favorable
outcome in our study. Despite this, surgery for advanced hyperparathyroidism
should optimally take place in the pre-transplant period.