Management of Post-transplant Hyperparathyroidism and Bone Disease

Drugs
Rowena Delos SantosThin Thin Maw

Abstract

Significant advances in immunosuppressive therapies have been made in renal transplantation, leading to increased allograft and patient survival. Despite improvement in overall patient survival, patients continue to require management of persistent post-transplant hyperparathyroidism. Medications that treat persistent hyperparathyroidism include vitamin D, vitamin D analogues, and calcimimetics. Medication side effects such as hypocalcemia or hypercalcemia, and adynamic bone disease, may lead to a decrease in the drugs. When medical management fails to control persistent post-transplant hyperparathyroidism, treatment is a parathyroidectomy. Surgical techniques are not uniform between centers and surgeons. Undergoing the surgery may include a subtotal technique or a technique including total parathyroid gland resection with partial heterotopic gland reimplantation. In addition, there are possible post-surgical complications. The ideal treatment for persistent post-transplant hyperparathyroidism is the treatment and prevention of the condition while patients are being managed for their late-stage chronic kidney disease and end-stage renal disease.

References

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Citations

Nov 5, 2019·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Hubert GolinganR Mack Harrell
Mar 15, 2020·Langenbeck's Archives of Surgery·Patorn Piromchai
Apr 15, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Elizabeth CohenDanielle Haakinson
Feb 10, 2021·Journal of Nephrology·Anca MateiDumitru D Branisteanu

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