Parathyroidectomy Outcomes in Renal Transplant Recipients: Subtotal vs. Total

Persistent hyperparathyroidism in renal transplant recipients has been associated with increased mortality and decreased allograft survival in up to 50% of patients. Management involves Cinacalcet and/or Parathyroidectomy and practices vary. Merits of subtotal vs. total parathyroidectomy have been debated and currently there is no consensus on best practice. In this single centre retrospective study, we identified patients that had a parathyroidectomy post transplantation between 1/01/2007 and 1/01/2017 (n=22) and graft survival and bone biochemistry were evaluated over a 12 month period. Patients with failed transplants and multiple transplants were excluded. Remaining 11 patients were divided into 2 groups –those that had subtotal parathyroidectomy (SP) vs. those that had total parathyroidectomy (TP) without auto transplantation.