6533b7d4fe1ef96bd1261f9b

RESEARCH PRODUCT

Intraoperative Parathyroid Hormone Monitoring During Parathyroidectomy for Hyperparathyroidism in Waiting List and Kidney Transplant Patients

Maurizio RomanoA. Di BonaGiovanni GambinoGiuseppe BuscemiEmerico LunaC. MaioneA.i. Lo MonteMaria Concetta GiovialeFiorella Calderone

subject

AdultMaleParathyroidectomymedicine.medical_specialtyWaiting Listsmedicine.medical_treatmentParathyroid hormoneTertiary hyperparathyroidismKidney transplantSubtotal ParathyroidectomyParathyroid GlandsMonitoring IntraoperativePreoperative Careparasitic diseasesmedicineHumansPostoperative PeriodKidney transplantationParathyroidectomyTransplantationHyperparathyroidismbusiness.industryHyperparathyroidismMiddle Agedmedicine.diseaseKidney TransplantationSurgeryAdult Female Humans Hyperparathyroidism/classification Hyperparathyroidism/etiology Hyperparathyroidism/surgery* Kidney Failure Chronic/complications* Kidney Transplantation* Male Middle Aged Monitoring Intraoperative/methods* Parathyroid Glands/surgery Parathyroid Hormone/blood* Parathyroidectomy* Postoperative Period Preoperative Care Waiting ListsParathyroid HormoneKidney Failure ChronicFemaleSurgerySecondary hyperparathyroidismbusiness

description

This report describes the use of the intraoperative parathyroid hormone (ioPTH) assay during parathyroidectomy in waiting list and transplanted patients. ioPTH levels were determined in 40 patients on the waiting list for kidney transplantation with secondary hyperparathyroidism who underwent subtotal parathyroidectomy and 9 transplanted patients with tertiary hyperparathyroidism who underwent removal of hyperplasic glands. Rapid PTH levels decreased significantly at each time period; the percentage decrease in rapid PTH levels was 61.3% among patients with IPT II and 70.2% in patients with IPT III at 10 minutes and 86.5% in patients with IPT II and 91% in patients with IPT III at 15 minutes after excision of hypersecreting parathyroid tissue. A decrease of 50% or more from baseline PTH levels at 10 minutes and/or a decrease of 85% or more at 15 minutes predicted successful removal of abnormal parathyroid glands. The application of this technique during subtotal parathyroidectomy has proved useful for correct excision of parathyroid glands among waiting list patients with IPT II, while in kidney transplant patients with IPT III it allowed removal of only the pathological glands with a limited surgical approach.

yearjournalcountryeditionlanguage
2006-06-08Transplantation Proceedings
https://doi.org/10.1016/j.transproceed.2006.02.140