UHN’s Ajmera Transplant Center Performs Landmark Parathyroid Transplant

The University Health Network’s (UHN) Ajmera Transplant Center performed a landmark parathyroid transplant in a patient suffering from severe hypoparathyroidism (little or no parathyroid function).

Only a few cases of parathyroid transplantation have been reported in the scientific literature, and this case is believed to be the first in North America.

Dr. Karen Devon, an endocrine surgeon in UHN’s Splott Department of Surgery, and her team were able to successfully complete the transplant at Toronto General Hospital in a second trial on May 19. Enough time has passed and the team can consider it as a success.

Patient Dawn Ethier, an Ottawa City police officer and mother of four, had been suffering from uncontrolled levels of PTH (a hormone produced by the parathyroid glands) for 10 years. She was hospitalized frequently, tried different treatments, and at one point she was taking about 100 pills a day to manage her symptoms. Her symptoms ranged from heart attacks, loss of muscle control in her limbs and face, seizures, and pulmonary embolism to long-term effects on her mental health.

Dawn’s hypoparathyroidism was due to complications after a surgical intervention to treat thyroid cancer. The cancer was cured by removing her thyroid, but she suffered from hypoparathyroidism as a complication of the surgery.

In this landmark transplant, a total of four parathyroid glands from deceased donors were surgically implanted into Dawn’s right forearm under local anesthesia. A few weeks after the successful transplant, the parathyroid glands were fully functional and she was off all medications for her hypoparathyroidism, greatly improving her quality of life.

This transplant is from Ontario Health (Trillium Gift of Life Network), who supported the logistics for this innovative treatment, including the development of a list of deceased parathyroid donors, with unwavering support from the leadership of the Ajmera Transplant Center and UHN. made possible by the unwavering support of It was also made possible thanks to the collaboration with the team at UHN’s Histocompatibility Lab, which conducted donor-recipient matching tests, and a generous donor to the UHN Foundation.

After this initial success, Dr. Devon and the team at the Ajmera Transplant Center are working to further research and expand parathyroid transplantation as a treatment for severe hypoparathyroidism.

About parathyroid and hypoparathyroidism

• Humans have four parathyroid glands, each about the size of a grain of rice, around the thyroid gland.

• Their function has nothing to do with the function of the thyroid gland.

• The parathyroid glands produce PTH, a hormone that controls calcium levels in the body. It regulates important functions such as muscle and nerve function, bone health, and has long-term effects on cardiovascular and mental health.

• Current treatment options for hypoparathyroidism include oral and intravenous vitamin D, calcium, and other mineral supplementation and PTH replacement, but in severe cases such as Dawn Ethier disease, these strategies are alone may not give the best results.

• The prevalence of hypoparathyroidism is estimated at 37 per 100,000 people annually in the United States.

Quotations

“This transplant saved my life and changed everything. It gave me my mood, my personality. I am no longer exhausted. I am able to spend more time with my children.” I can see the future now.This is not happening.To be the one that will take me.” – Dawn Ethier, Patient

“I was apprehensive about bringing this idea up to the leadership of the Ajmera Transplant Center and was very pleasantly surprised by the response that I had an obligation to help this patient. – Dr. Karen Devon, Endocrine Surgeon in UHN’s Splott Department of Surgery and Associate Professor at the University of Toronto

“This was truly a team effort. It’s always exciting to be involved in something new and I was thrilled to see the success of this case.” – Kathryn Tinckam, Ph.D., Nephrotransplant Specialist, Ajmera Transplant Centre, Consultant at HLA Lab, Chief Physician at UHN, Associate Professor at T University

“Innovation is in the DNA of Ajmera Transplant Center and UHN. This opens up exciting new opportunities for treating patients with severe hypoparathyroidism.” – Dr. Atul Humar, Director, Ajmera Transplant Center, UHN, Professor, University of Toronto.

“Ontario Health (Trillium Gift of Life Network) is proud to have led our collaboration with UHN to develop the standards, resources and education needed to facilitate transplant success. Thanks to the commitment and dedication of our partners, more patients will be able to perform transplants and enjoy vastly improved lives as a result of this innovative work. Breakthrough medical advances in human donation and transplantation are only possible through the generosity of donors and their families. We will continue to serve.” – Rebecca Cooper, Vice President, Ontario Health (Trillium Gift of Life Network and Ontario Renal Network)