Simultaneous Kidney and Parathyroid Transplantation in the Management of Genetic Hypoparathyroidism in a Child.

Autor:	Vallant N; Department of Nephrology and Transplantation, Guy's Hospital, London, United Kingdom.; Department of Paediatric Nephrology, Evelina London Children's Hospital, London, United Kingdom.; Department of Paediatric Nephrology, Great Ormond Street Hospital, London, United Kingdom., Sinha MD; Department of Paediatric Nephrology, Evelina London Children's Hospital, London, United Kingdom.; Kings College London, Division of Surgery, London, United Kingdom., Cheung M; Department of Paediatric Endocrinology, Evelina London Children's Hospital, London, United Kingdom., Ware N; Department of Paediatric Nephrology, Evelina London Children's Hospital, London, United Kingdom., Jones H; Department of Paediatric Nephrology, Evelina London Children's Hospital, London, United Kingdom., Buck J; Department of Paediatrics, Ipswich Hospital, London, United Kingdom., Boffa C; Department of Nephrology and Transplantation, Guy's Hospital, London, United Kingdom., Irving M; Department of Paediatric Nephrology, Great Ormond Street Hospital, London, United Kingdom.; Department of Genetics, Guy's Hospital, London, United Kingdom., Carroll PV; Department of Endocrinology, Guy's Hospital, London, United Kingdom., Hubbard J; Department of Endocrinology, Guy's Hospital, London, United Kingdom., Gökmen R; Department of Nephrology and Transplantation, Guy's Hospital, London, United Kingdom., Rees L; Department of Paediatric Nephrology, Great Ormond Street Hospital, London, United Kingdom., Gogalniceanu P; Department of Nephrology and Transplantation, Guy's Hospital, London, United Kingdom.; Kings College London, Division of Surgery, London, United Kingdom., Kessaris N; Department of Nephrology and Transplantation, Guy's Hospital, London, United Kingdom.; Department of Paediatric Nephrology, Evelina London Children's Hospital, London, United Kingdom.; Department of Paediatric Nephrology, Great Ormond Street Hospital, London, United Kingdom.; Kings College London, Division of Surgery, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2022 Mar 16; Vol. 8 (4), pp. e1284. Date of Electronic Publication: 2022 Mar 16 (Print Publication: 2022).
DOI:	10.1097/TXD.0000000000001284
Abstrakt:	Background: Genetically determined hypoparathyroidism can lead to life-threatening episodes of hypocalcemia and, more rarely, to end-stage kidney disease at a young age. Parathyroid allotransplantation is the only curative treatment, and in patients already receiving immunosuppression for kidney transplantation, there may be little additional risk involved. We report the first such case in a child. Methods: An 11-y-old girl, known to have hypoparathyroidism secondary to an activating pathogenic variant in the calcium-sensing receptor, developed end-stage kidney disease and was started on intermittent hemodialysis. Since the age of 2.5 y, she had been receiving treatment with exogenous synthetic parathyroid hormone (PTH). In June 2019, at the age of 11.8 y, she received a living-donor kidney and simultaneous parathyroid gland transplant from her father. The kidney was implanted into the right iliac fossa, followed by implantation of the parathyroid gland into the exposed rectus muscle. Results: The kidney graft showed immediate function while the intrinsic serum PTH level remained low at 3 ng/L. Exogenous PTH infusion was reduced on day 6 posttransplantation to stimulate PTH production by the new gland, which resulted in improving intrinsic PTH concentrations of 28 ng/L by day 9. Twelve months after transplantation, PTH levels remain in normal range and the kidney graft function is stable with a serum creatinine of 110 μmol/L. Conclusions: Simultaneous living donation and transplantation of a kidney and a parathyroid gland into a child is safe and feasible and has the potential to cure primary hypoparathyroidism as well as kidney failure. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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