title: Simultaneous Living Donor Kidney and Parathyroid Allotransplantation: First Case Report and Review of Literature.
abstract: 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.
authors.affiliation: 1Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, IL. 2Division of Minimally Invasive Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL. 3Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL.
authors.forename: Raquel
authors.initials: R
authors.lastname: Garcia-Roca
authors.forename: Sandra
authors.initials: S
authors.lastname: Garcia-Aroz
authors.forename: Ivo G
authors.initials: IG
authors.lastname: Tzvetanov
authors.forename: Pier Cristoforo
authors.initials: PC
authors.lastname: Giulianotti
authors.forename: Maya
authors.initials: M
authors.lastname: Campara
authors.forename: Jose
authors.initials: J
authors.lastname: Oberholzer
authors.forename: Enrico
authors.initials: E
authors.lastname: Benedetti
mesh_terms: D000328:Adult; D002118:Calcium / Q000627:therapeutic use; D005260:Female; D006680:HLA Antigens / Q000737:chemistry; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D009397:Nephrocalcinosis / Q000601:surgery*; D010280:Parathyroid Glands / Q000601:surgery* / Q000637:transplantation*; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000379:methods*; D051437:Renal Insufficiency / Q000601:surgery; D065287:Robotic Surgical Procedures; D035781:Siblings; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D007166:Immunosuppressive Agents; D010281:Parathyroid Hormone; D002118:Calcium