University of Alabama at Birmingham, Department of Surgery, Division of Breast and Endocrine Surgery, Birmingham, AL, USA.
Am J Surg. 2022 Apr;223(4):652-661. doi: 10.1016/j.amjsurg.2021.07.025. Epub 2021 Jul 20.
Hypoparathyroidism is the most common complication of bilateral operations in the central neck. No formal guidelines exist for the management of permanent hypoparathyroidism. Current treatment involving medical supplementation increases resource utilization and patient morbidity while decreasing quality of life. Parathyroid allotransplant (PA) offers a promising therapy; however, the optimal technique and role of immunosuppression (IS) in PA remain unclear.
We performed a systematic search of the Embase, MEDLINE, and Cochrane Library databases to identify studies investigating PA for treatment of hypoparathyroidism.
A total of 24 studies including 186 individual allograft transplants in 146 patients were identified. Pooled graft survival for allotransplants in transplant-naïve vs prior transplant recipients was 29.9% and 80%, respectively.
PA using normocellular, fresh parathyroid donor tissue that is ABO-compatible, with induction and, at minimum, short-term maintenance IS presents a potentially safe and effective therapeutic option for permanent hypoparathyroidism in patients tolerating IS.
甲状旁腺功能减退症是中央颈部双侧手术最常见的并发症。目前尚无针对永久性甲状旁腺功能减退症管理的正式指南。目前的治疗方法包括药物补充，这增加了资源利用和患者发病率，同时降低了生活质量。甲状旁腺同种异体移植（PA）提供了一种有前途的治疗方法；然而，PA 中最佳技术和免疫抑制（IS）的作用仍不清楚。
我们对 Embase、MEDLINE 和 Cochrane 图书馆数据库进行了系统检索，以确定研究 PA 治疗甲状旁腺功能减退症的研究。
共确定了 24 项研究，包括 146 名患者的 186 个单独同种异体移植。在无移植史和既往移植受者中，同种异体移植的移植物存活率分别为 29.9%和 80%。
使用正常细胞、新鲜的甲状旁腺供体组织，ABO 相容，诱导和至少短期维持 IS，对于能够耐受 IS 的永久性甲状旁腺功能减退症患者，PA 是一种潜在安全有效的治疗选择。
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