[Heterologous transplantation of human parathyroid glands after microencapsulation with clinically suitable alginate...

The role of parathyroid transplantation for the therapy of permanent hypoparathyroidism is undisputed. Because the parathyroid hormone deficiency syndromee rarely every is a vital thread to patients affected, systemic immunosuppression for transplant recipients is not justified. A technique of microencapsulation was modified for transplantation of parathyroid tissue. Using a core substance suitable for clinical use (amitogenic alginate), we accomplished allotransplantation of functioning parathyroid tissue in the long-term animal model and, very recently, reported first clinical cases without postoperative immunosuppression. In a controlled animal model of totally parathyroidectomized rats (PTX, two groups of n = 40), we investigated the ability of microencapsulation with the amitogenic alginate to enable transplantation across the highest immunological barrier (xenotransplantation: human-rat); to ensure intact transplant function and to protect from rejection. Rat parathyroid hormone (PTHRA i.S.) and serum calcium levels served as parameters of completeness of PTX; intact human PTH (PTHRA i.S.) and serum calcium levels of recipient animals were used to assess graft function. Also, tissue integrity within explanted capsules was assessed by histology. Cultured and microencapsulated parathyroid tissue resumes and maintains function in vivo, even if transplanted across the highest immunological barrier. Functionally, PTHHU i.S. replaced (PTHRA i.S.) in PTX animals entirely and restored normocalcemia. These results suggest, that xeno-transplantation of the parathyroids can be achieved without postoperative immuno-suppression in a long term animal model. These data also imply the possibility of clinical heterotransplantation of parathyroid glands.