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采用新技术的甲状旁腺同种异体移植:一项前瞻性临床试验。

Parathyroid Allotransplant With a New Technique: A Prospective Clinical Trial.

作者信息

Aysan Erhan, Altug Burcugul, Ercan Cilem, Kesgin Toka Cemile, Idiz Ufuk Oguz, Muslumanoglu Mahmut

机构信息

From the Department of General Surgery, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.

出版信息

Exp Clin Transplant. 2016 Aug;14(4):431-5. doi: 10.6002/ect.2014.0294. Epub 2014 Sep 16.

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

摘要

目的

甲状旁腺同种异体移植是治疗永久性甲状旁腺功能减退症的一种有价值的替代方法。然而,这是一个困难的过程,需要若干训练有素的工作人员和先进的实验室设备,这使得成本很高。在此,我们确定了一种新的甲状旁腺同种异体移植技术。

材料与方法

在获得患者知情同意后,将因慢性肾衰竭接受甲状旁腺次全切除术的4名供体的甲状旁腺细胞悬液在短期细胞培养后移植到10例永久性甲状旁腺功能减退症患者中。泼尼松龙在前10天用作免疫抑制剂,此后停用。

结果

平均随访12个月时,7例患者(70%)观察到移植物功能。7例患者完全停止每日口服钙和维生素D补充剂。未观察到任何主要或次要并发症。

结论

我们的技术简单、快速且成本低,平均随访12个月时成功率为70%。它需要的工作人员少、设备最少,且维持使用短期免疫抑制剂。本研究中提到的甲状旁腺同种异体移植技术的发展可能对治疗永久性甲状旁腺功能减退症具有重要意义。

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