Ayşan Erhan, Düzköylü Yiğit, Can İsmail, Büyükpınarbaşılı Nur
Department of General Surgery, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey.
Department of General Surgery, İstanbul Training and Research Hospital, İstanbul, Turkey.
Turk J Surg. 2017 Jun 1;33(2):91-95. doi: 10.5152/turkjsurg.2017.3427. eCollection 2017.
Parathyroid allotransplantation is a new method for the treatment of permanent hypoparathyrodism. Adenoma cells are not used for transplantation because of the potential for functional or histopathologic transformation. In this study, we transplanted human adenomatous parathyroid cells to rabbits.
Parathyroid adenoma tissue taken from a male patient was cryopreserved and transplanted into seven New Zealand white rabbits (mean weight, 3700±220 g; mean age, 4.5 months) under immunosuppression. The levels of parathormone, calcium and phosphorus were measured before and after transplantation, and the parathyroid cells were observed histopathologically.
Mean parathyroid hormone level was 0.5 pg/dL before transplantation and 6.6 pg/dL after transplantation (p<0.05). Preoperative mean calciumlevel was 14.1 mg/dL, and mean phosporus level was 3.5 mg/dL before transplantation while these values were 14.4 mg/dL and 3.3 mg/dL, respectively, after transplantation (p>0.05). Morphologic transformation was not observed in parathyroid cells after transplantation.
In short-term observation, adenomatous parathyroid cells can function without malignant transformation. In the future, the preliminary methodology in this study may serve as a safe alternative for allotransplantation into patients with permanent hypoparathyroidism.
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新方法。由于存在功能或组织病理学转变的可能性,腺瘤细胞不用于移植。在本研究中,我们将人甲状旁腺腺瘤细胞移植到兔子体内。
取自一名男性患者的甲状旁腺腺瘤组织经冷冻保存后,在免疫抑制下移植到7只新西兰白兔体内(平均体重3700±220 g;平均年龄4.5个月)。在移植前后测量甲状旁腺激素、钙和磷的水平,并对甲状旁腺细胞进行组织病理学观察。
移植前甲状旁腺激素平均水平为0.5 pg/dL,移植后为6.6 pg/dL(p<0.05)。术前平均钙水平为14.1 mg/dL,移植前平均磷水平为3.5 mg/dL,而移植后这些值分别为14.4 mg/dL和3.3 mg/dL(p>0.05)。移植后甲状旁腺细胞未观察到形态学转变。
在短期观察中,甲状旁腺腺瘤细胞可以发挥功能而不发生恶性转化。未来,本研究中的初步方法可能成为永久性甲状旁腺功能减退症患者同种异体移植的一种安全替代方法。