caa a22 4500 475803655 CHVBK 20180406123744.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s002680010230 doi (NATIONALLICENCE)springer-10.1007/s002680010230 Persistent Hyperparathyroidism Requiring Surgical Treatment after Kidney Transplantation [Elektronische Daten] [Paul Kinnaert, Nathalie Nagy, Christine Decoster-Gervy, Luc De Pauw, Isabelle Salmon, Pierre Vereerstraeten] There are not many publications describing long-term follow-up of persistent hyperparathyroidism requiring surgical treatment after kidney transplantation (PHSKT). In some patients adenomas, rather than multiglandular disease, have been incriminated as the cause of PHSKT. We reviewed the charts of 45 patients followed for 12 to 146 months (median 45 months) after parathyroidectomy for PHSKT. We compared them with (1) those of 951 patients receiving a kidney graft during the same period but not submitted to parathyroidectomy or (2) 90 matched controls selected from this cohort to determine the characteristics of PHSKT patients. The duration of pretransplant dialysis was significantly longer in PHSKT patients than in controls (5.78 ± 0.41 vs. 3.41 ± 0.24 years; p < 0.0001). A total of 166 glands were removed or biopsied. Except for one questionable case, no true adenoma was observed even when only one gland was enlarged. The outcome of surgery was not influenced by the technique (subtotal parathyroidectomy versus total parathyroidectomy and autografting) but depended on the amount of resected parathyroid tissue: no failures and 4 cases of hypoparathyroidism in 34 cases with no missing gland at cervical exploration; 3 failures and no permanent hypoparathyroidism in 11 cases with one or two missing glands. Excision of the enlarged glands only was sufficient to cure the patient. No recurrence was observed. Our results suggest that single gland enlargement in PHSKT results in most cases from different rates of involution of the parathyroids after successful kidney transplantation. When fewer than four glands are discovered, resection of all visible glands with or without grafting corrects hypercalcemia in more than 70% of the cases. Société Internationale de Chirurgie, 2000 Kinnaert Paul Département Médico-chirurgical de Néphrologie, Dialyse, et Transplantation, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut Nagy Nathalie Service d'Anatomo-pathologie, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut Decoster-Gervy Christine Service de Chimie, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut De Pauw Luc Département Médico-chirurgical de Néphrologie, Dialyse, et Transplantation, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut Salmon Isabelle Service d'Anatomo-pathologie, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut Vereerstraeten Pierre Département Médico-chirurgical de Néphrologie, Dialyse, et Transplantation, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1391-1395 0364-2313 24:11<1391 2000 24 268 https://doi.org/10.1007/s002680010230 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010230 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kinnaert Paul Département Médico-chirurgical de Néphrologie, Dialyse, et Transplantation, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut NATIONALLICENCE 700 1- Nagy Nathalie Service d'Anatomo-pathologie, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut NATIONALLICENCE 700 1- Decoster-Gervy Christine Service de Chimie, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut NATIONALLICENCE 700 1- De Pauw Luc Département Médico-chirurgical de Néphrologie, Dialyse, et Transplantation, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut NATIONALLICENCE 700 1- Salmon Isabelle Service d'Anatomo-pathologie, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut NATIONALLICENCE 700 1- Vereerstraeten Pierre Département Médico-chirurgical de Néphrologie, Dialyse, et Transplantation, Cliniques Universitaires de Bruxelles-Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium, BE aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1391-1395 0364-2313 24:11<1391 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer