Intraoperative parathyroid hormone monitoring during parathyroidectomy for hyperparathyroidism in waiting list and kidney transplant patients

Maurizio Romano, Maria Concetta Gioviale, Attilio Ignazio Lo Monte, Giuseppe Buscemi, Emerico Luna, Alessandro Di Bona, Fiorella Calderone, Giovanni Gambino

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)1003-1005
Number of pages3
JournalTransplantation Proceedings
Volume38
Publication statusPublished - 2006

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

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