Academic Journal

Surgical treatment of persistent hyperparathyroidism after renal transplantation

التفاصيل البيبلوغرافية
العنوان: Surgical treatment of persistent hyperparathyroidism after renal transplantation
المؤلفون: Triponez, Frédéric, Clark, Orlo H., Vanrenthergem, Yves, Evenepoel, Pieter
المصدر: ISSN: 0003-4932 ; Annals of surgery, vol. 248, no. 1 (2008) p. 18-30.
سنة النشر: 2008
المجموعة: Université de Genève: Archive ouverte UNIGE
مصطلحات موضوعية: info:eu-repo/classification/ddc/617, Cryopreservation, Diagnostic Imaging, Disease Progression, Humans, Hypercalcemia/complications, Hyperparathyroidism/drug therapy/etiology/physiopathology/surgery, Hypophosphatemia/etiology/physiopathology, Kidney Failure, Chronic/complications/metabolism, Kidney Transplantation, Monitoring, Intraoperative, Naphthalenes/therapeutic use, Parathyroid Hormone/analysis, Parathyroidectomy/methods, Postoperative Complications/epidemiology/physiopathology/surgery, Thymectomy
الوصف: OBJECTIVE: To provide a review on current knowledge about the pathogenesis, epidemiology, and clinical complications of persistent hyperparathyroidism after kidney transplantation (3HPT) and to discuss the surgical approaches. BACKGROUND: 3HPT usually regresses within the first months after transplantation. Parathyroidectomy for 3HPT is therefore not usually needed. Consequently, few studies have been published regarding the best medical management for 3HPT and indications for parathyroidectomy. METHODS: Medical literature databases were searched for studies on the surgical treatment of 3HPT published in English. RESULTS: Forty-one studies were identified and included in this review. CONCLUSIONS: 3HPT most commonly occurs in patients who have severe secondary hyperparathyroidism at the time of transplantation. Indications for parathyroidectomy in patients with 3HPT include persistent severe hypercalcemia, defined as a serum calcium level greater than 11.5 mg/dl, unexplained renal function deterioration, or progressive bone mineral density loss. Published studies suggest that the best surgical approach for patients with 3HPT is subtotal parathyroidectomy or total parathyroidectomy with autotransplantation. 3HPT poses important health risks, particularly concerning bone density and the cardiovascular system. Because spontaneous improvement of parathyroid function is uncommon after 3 months of transplantation, waiting for more than 6 months before parathyroidectomy should be discouraged.
نوع الوثيقة: article in journal/newspaper
اللغة: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/18580203; https://archive-ouverte.unige.ch/unige:1171; unige:1171
الاتاحة: https://archive-ouverte.unige.ch/unige:1171
Rights: info:eu-repo/semantics/restrictedAccess
رقم الانضمام: edsbas.4C7D9B8
قاعدة البيانات: BASE