Percutaneous ethanol injection therapy in post-transplant patients with secondary hyperparathyroidism

Persistent hyperparathyroidism is frequent in postrenal transplant patients. Percutaneous ethanol injection therapy (PEIT) is an alternative for treatment of patients with secondary hyperparathyroidism but it was not described in postrenal transplant patients. We report our experience with PEIT to control hyperparathyroidism in the post-transplant period. We performed PEIT under ultrasonographic guidance and local anesthesia in eight patients because of persistent secondary hyperparathyroidism after renal transplantation. Indications for PEIT were: high intact parathyroid hormone (iPTH) levels with hypercalcemia, hypophosphatemia, osteopenia and/or bone pain. All patients had at least one visible parathyroid nodule by ultrasonography. Biochemical assays were performed immediately before PEIT, between 1 and 7 days after last PEIT, and a mean of 8.0 ± 2.8 months after PEIT. Serum iPTH and calcium levels decreased significantly after treatment and remained unchanged until final control. Serum iPTH decreased from 286.9 ± 107.2 to 154.6 ± 42.2 pg/ml (P < 0.01) after PEIT (percentual reduction 36.5 ± 9.5%). This response was significantly correlated to total ethanol volume used (r: 0.94, P < 0.0001). Hypercalcemia disappeared in six of eight patients treated. Only minor complications were registered. There were no changes in renal function related to the treatment. Our findings show that PEIT is a useful and safe alternative for patients with persistent post-transplant secondary hyperparathyroidism.Fil: Douthat, Walter Guillermo. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Orozco, Santiago E. Department of Radiology, Hospital Privado-Centro Médico de Córdoba, Córdoba, ArgentiFil: Maino, Pablo. Department of Radiology, Hospital Privado-Centro Médico de Córdoba, Córdoba, ArgentinaFil: Cardozo, Gabriela. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Arteaga, Javier de. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Fuente, Jorge de la. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Chirchiu, Carlos R. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Massari, Pablo U. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentin