Direct revascularization is superior for rat parathyroid allotransplantation with FK506.
Parathyroid gland allotransplantation has been a challenging goal for decades. Our objective was to optimize a parathyroid allotransplantation model for analysis of short-term or low-dose immunosuppressive regimens. Rats that had undergone parathyroidectomy received parathyroid allografts either by direct microvascular anastomoses as part of a composite laryngotracheal graft or by direct implantation into hind limb muscle. All rats were maintained on daily low-dose FK506 (tacrolimus). Intact serum parathyroid hormone (PTH) levels for both groups were recorded over a period of at least 45 days and compared with a repeated-measures mixed model. We found that microvascular anastomosis was superior to implantation for parathyroid gland survival, as all revascularized grafts immediately produced normal levels of PTH, whereas implanted grafts had a significantly slower recovery of function (p < .001). Four of the 11 implanted grafts (36%) never produced detectable PTH levels. Using this model, we are developing innovative strategies that will lead to successful parathyroid allotransplantation without the need for chronic immunosuppression.
Nelson
Marc
M
Cleveland Clinic Foundation, Head and Neck Institute, Cleveland, Ohio, USA.
Dan
Olivia
O
Strome
Marshall
M
D000714:Anastomosis, Surgical; D000818:Animals; D006614:Hindlimb / Q000098:blood supply; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007830:Larynx / Q000637:transplantation; D008297:Male; D008866:Microsurgery; D023421:Models, Animal; D018482:Muscle, Skeletal / Q000098:blood supply; D010280:Parathyroid Glands / Q000098:blood supply* / Q000637:transplantation*; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D051381:Rats; D016559:Tacrolimus / Q000008:administration & dosage*; D014184:Transplantation, Homologous / Q000379:methods
D007166:Immunosuppressive Agents; D010281:Parathyroid Hormone; D016559:Tacrolimus