title: Total parathyroidectomy without autotransplantation in dialysis patients and renal transplant recipients, long-term follow-up evaluation.
abstract: BACKGROUND
  Persistent secondary hyperparathyroidism not responding to medication is treated successfully with surgical excision of parathyroid glands (total parathyroidectomy [PTX]). PTX without autotransplantation of parathyroid glands excludes the risk for recurrence of hyperparathyroidism.
  
  
  METHODS
  During the years 2002 to 2005, 36 total parathyroidectomies were performed in 33 patients: 21 dialysis patients because of end-stage renal disease and 12 renal transplant recipients.
  
  
  RESULTS
  PTX without autotransplantation was performed successfully in 33 patients, whereas 3 patients were reoperated for remaining parathyroid glands. Immediate improvement of clinical symptoms and a decrease of serum calcium and parathormone levels were observed after surgical procedures. Oral replacement treatment with vitamin D (1a-calcidiol) and calcium was commenced and long-term follow-up evaluation (23.5 +/- 7.6 mo) showed that calcium homeostasis was controlled adequately.
  
  
  CONCLUSIONS
  PTX without autotransplantation is a safe and effective surgical procedure for the treatment of resistant secondary hyperparathyroidism with immediate response of clinical symptoms. Replacement treatment with vitamin D and calcium provides satisfactory coverage of individual needs.
authors.affiliation: Transplant Unit, Evangelismos General Hospital of Athens, 45-47 Ipsilantou Street, Athens 10676, Greece.
authors.forename: Spiros
authors.initials: S
authors.lastname: Drakopoulos
authors.forename: Maria
authors.initials: M
authors.lastname: Koukoulaki
authors.forename: Theofanis
authors.initials: T
authors.lastname: Apostolou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Pistolas
authors.forename: Katerina
authors.initials: K
authors.lastname: Balaska
authors.forename: Stylianos
authors.initials: S
authors.lastname: Gavriil
authors.forename: Valsamakis
authors.initials: V
authors.lastname: Hadjiconstantinou
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D018771:Arthralgia / Q000209:etiology; D002114:Calcinosis / Q000209:etiology; D002118:Calcium / Q000097:blood; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D010280:Parathyroid Glands / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D010758:Phosphorus / Q000097:blood; D011537:Pruritus / Q000209:etiology; D006435:Renal Dialysis
chemical_list: D010281:Parathyroid Hormone; D010758:Phosphorus; D000469:Alkaline Phosphatase; D002118:Calcium