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Khirurgii

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Year 2013 Vol. 21 No 6

TRANSPLANTOLOGY

V.JA. KHRYSHCHANOVICH1, S.I. TRETYAK1, A.N. KHARLAMOVA1, V.A. KONDRATOVICH2, A.M. PISARENKO2, E.I. KUZMENKOVA3, A.V. ROMANOVICH4, A.V. BOLSHOV1

RESULTS OF PARATHYROID ALLOTRANSPLANTATION

EE “Belarusian State Medical University” 1,
ME “Minsk City Clinical Oncologic Dispensary”2,
SE “Republican Center of Medical Rehabilitation and Balneotherapy”3,
ME “The 4th Municipal Clinical Hospital named after N.E. Savchenko”4, Minsk
The Republic of Belarus

Objectives. To evaluate the effectiveness of macroencapsulated parathyroid cells allotransplantation into the arterial bed of patients with postoperative hypoparathyroidism and without immunosupression application.
Methods. From December 2010 to November 2011 7 patients underwent to 7 allotransplantations of cultured macroencapsulated parathyroid cells it was indicated by the iatrogenic hypoparathyroidism after the thyroid surgery in all cases. An average recipient age was 52 [39-59] years. Donors were selected from patients undergoing parathyroidectomy for primary (adenoma) and secondary (due to chronic renal failure) hyperparathyroidism.
Results. The cultivated cells with high concentration of parathormone in the cultured liquid (2927,5 [1400,5-4847] pg/ml) and the degree of viability (99%) were selected for the transplantation. The median cellular allograft survival was 3 [1-9] months. In 4 patients (57,1%) the allografts retained their endocrine function for more than 2 months. None of the patients showed clinical symptoms of hyperparathyroidism in the posttransplantation follow-up period.
Conclusions. In some patients with hypoparathyroidism developed after the thyroid surgery, parathyroid cell allotransplantation is considered to be an effective therapeutic alternative vs the standard methods. Donors’ and recipients’ age, the duration of hypoparathyroidism didn’t influence significantly on the terms of the graft functioning. The problems concerning porosity, biocompatibility, long-term stability of the microporous membranes demand on the further investigation as well as the necessity of ABO- and HLA-matching of donor-recipient pairs and requirement for immunosuppression application.

Keywords: parathyroid culture, endocrine cells allotransplantation, immunosuppression free, surgical hypoparathyroidism, cell therapy
p. 68 – 77 of the original issue
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Address for correspondence:
220116, Respublika Belarus', g. Minsk, pr-t Dzerzhinskogo, d. 83, UO «Belorusskii gosudarstvennyi meditsinskii universitet», 2-ia kafedra khirurgicheskikh boleznei,
e-mail: vladimirkh77@mail.ru,
Khryshchanovich Vladimir Ianovich
Information about the authors:
Khryshchanivich V.Ja. PhD, associate professor of the 2nd chair of surgical diseases of EE “Belarusian State Medical University”.
Tretyak S.I. MD, professor, a head of the 2nd chair of surgical diseases of EE “Belarusian State Medical University”.
Kharlamova A.N. A researcher of the scientific-practical department of EE “Belarusian State Medical University”.
Kondratovich V.A. Deputy chief physician of ME “Minsk City Clinical Oncologic Dispensary”.
Pisarenko A.M. A head of the department of head and neck tumors of ME “Minsk City Clinical Oncologic Dispensary”.
Kuzmenkova E.I. PhD, a head of the endocrinology department of SE “Republican Center of Medical Rehabilitation and Balneotherapy”.
Romanovich A.V. An angiosurgeon of ME “The 4th City Clinical Hospital named after N.E. Savchenko”.
Bolshov A.V. PhD, assistant of the 2nd chair of surgical diseases of EE “Belarusian State Medical University”.
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