Langenbeck's Archives of Surgery

, Volume 391, Issue 6, pp 561–565 | Cite as

Accuracy of intra-operative PTH measurement during subtotal parathyroidectomy for tertiary hyperparathyroidism after renal transplantation

  • Frederic Triponez
  • David Dosseh
  • Marc Hazzan
  • Christian Noel
  • Benoit Soudan
  • Jonathan Lokey
  • Martha Mozzon
  • Charles A. G. Proye
Original Article

Abstract

Background and aims

Intra-operative parathyroid hormone (IOPTH) results are not known in the setting of tertiary hyperparathyroidism (HPT) after renal transplantation.

Materials and methods

A retrospective analysis of 35 tertiary HPT patients who all underwent subtotal parathyroidectomy and IOPTH monitoring was conducted.

Results

The mean follow-up time was 2.2±1.4 years. Thirty-four patients were cured; one patient (2.8%) had a persistent disease and was cured after reoperation. Median parathyroid hormone (PTH) (median percent decrease from highest) at baseline and at 5, 10, 20, and 30 min were 244, 78 (69%), 63 (75%), 53 (79%), and 49 pg/ml (83%), respectively. Four patients who were cured had a decrease of <50% at 5 min and two of them had a decrease of <50% at 10 min. The patient with persistent disease had a decrease of >50% at 10 min. The sensitivity of the test was 94% at 10 min using the Miami criteria.

Conclusion

This study shows that IOPTH in tertiary hyperparathyroidism has a high sensitivity. However, because of the low risk of persistent hyperparathyroidism when a subtotal parathyroidectomy is performed, its potential impact on the overall success rate is very small. We therefore do not recommend the routine use of IOPTH in tertiary hyperparathyroidism.

Keywords

Hyperparathyroidism Renal transplantation Intra-operative PTH 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Frederic Triponez
    • 1
    • 4
  • David Dosseh
    • 1
  • Marc Hazzan
    • 2
  • Christian Noel
    • 2
  • Benoit Soudan
    • 3
  • Jonathan Lokey
    • 1
  • Martha Mozzon
    • 1
  • Charles A. G. Proye
    • 1
  1. 1.General and Endocrine SurgeryUniversity Hospital of LilleLilleFrance
  2. 2.Nephrology and HemodialysisUniversity Hospital of LilleLilleFrance
  3. 3.Laboratory of Endocrinological BiochemistryUniversity Hospital of LilleLilleFrance
  4. 4.Thoracic and Endocrine SurgeryUniversity Hospital of GenevaGenevaSwitzerland

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