Simultaneous Living Donor Kidney and Parathyroid Allotransplantation

Abstract

In Brief Background Congenital hypoparathyroidism can be severely debilitating for patients, leading to renal failure at young age. Parathyroid transplantation may represent a permanent parathyroid replacement therapy. In patients already on immunosuppression for other organ transplant, there is little additional risk involved with parathyroid allotransplantation. Methods Robotic assisted transaxillary single parathyroidectomy is performed on a living donor also donating a kidney to her sibling. Results Recipient total serum PTH levels became detectable after 3 days from the procedure and maintained for 9 months after transplant with minimal calcium supplementation after the procedure. Literature review and previous results are summarized. Conclusions Obtaining a parathyroid gland and a kidney from the same donor reduces the exposure to different HLA antigens. The combined procedure using minimally invasive surgery is safe, with the additional cosmetic advantage and convenience for the willing donor. In the setting of need for immunosuppression, additional transplantation to treat the cause is safe and justified in the recipients. This is a case report of a successful combined parathyroid and kidney transplantation in a patient with congenital hypoparathyroidism. Using robotic-assisted, trans-axillary, single parathyroidectomy the authors suggest that the procedure is safe, cosmetic, and convenient for the living donor.