US-guided percutaneous radiofrequency ablation of secondary hyperparathyroidism as a bridge to renal transplantation

PURPOSE: Secondary hyperparathyroidism (SHPT) is a frequently encountered problem in patients with end-stage renal disease (ESRD) prior to renal transplantation (RTP), and the successful management of SPHP currently is challenging. In this study, we aimed to investigate the effectiveness of radiofrequency ablation (RFA) for SHPT as a bridge to RTP and to evaluate post-transplantation outcomes.

METHODS: Patients with SHPT receiving RFA treatment were retrospectively reviewed, and those underwent RTP after ablation were enrolled. Serum parathyroid hormone (PTH), calcium, and phosphate levels were collected before ablation and at follow-up periods. The primary endpoints are PTH values at time of transplantation and at the final follow-up. The secondary endpoints were RFA-related complications, serum calcium and phosphate concentrations, and allograft function.

RESULTS: Eleven patients with 43 enlarged parathyroid glands were treated with 16 RFA sessions and enrolled in the study. Complete ablation was achieved in all glands with transient hoarseness and hypocalcemia occurring in two and five of the treatments, respectively. At time of transplantation, serum PTH levels (246.7 ± 182.6 pg/mL) were significantly lower than that before RFA (1666.55 ± 874.48 pg/mL, p < 0.001) and were all within guideline-oriented range. The median follow-up period was 57.2 months. At last visit, all patients were alive, with normal PTH values and functioning grafts.

CONCLUSIONS: Ultrasound-guided RFA is effective for destroying hyperplastic parathyroid tissues in SHPT patients, whose PTH values fall within the guideline-oriented range both pre-and post-transplantation. Percutaneous RFA acts as an effective bridge to RTP and might provide a new management paradigm designed to improve post-transplant outcomes.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:40

Enthalten in:

International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group - 40(2023), 1 vom: 05., Seite 2223370

Sprache:

Englisch

Beteiligte Personen:

Yue, Wenwen [VerfasserIn]
Jiang, Tingting [VerfasserIn]
Deng, Erya [VerfasserIn]
Chai, Huihui [VerfasserIn]
Weng, Ning [VerfasserIn]
He, Hongfeng [VerfasserIn]
Zhang, Zhengxian [VerfasserIn]
Xu, Dong [VerfasserIn]
Peng, Chengzhong [VerfasserIn]

Links:

Volltext

Themen:

Calcium
Hyperparathyroidism
Journal Article
Parathyroid Hormone
Parathyroid hormone
Phosphates
Radiofrequency ablation
Renal transplantation
Research Support, Non-U.S. Gov't
SY7Q814VUP
Thermal ablation

Anmerkungen:

Date Completed 23.06.2023

Date Revised 27.06.2023

published: Print

Citation Status MEDLINE

doi:

10.1080/02656736.2023.2223370

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM358458358