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Abstract: TH-PO823

Impact of Hyperparathyroidism and Its Different Subtypes on Long-Term Graft Outcome: A Single Transplant Center Cohort Study

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Alfieri, Carlo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Molinari, Paolo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Regalia, Anna, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Pisacreta, Anna Maria, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Cicero, Elisa, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Re Sartò, Giulia Vanessa, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Castellano, Giuseppe, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
Background

We studied the association between parathormone (PTH) levels and long-term graft loss in RTx patients (RTx-p).

Methods

We retrospectively evaluated 871 RTx-p, transplanted in our unit from Jan-2004 to Dec-2020 assessing renal function and mineral metabolism parameters at 1, 6 and 12 months after RTx. Graft loss and death with functioning graft during follow-up (FU, 8.3[5.4-11.4] years) were checked.

Results

At month-1, 79% had HPT, of which 63% with secondary HPT (SHPT) and 16% tertiary HPT (THPT); at month-6, HPT prevalence was 80% of which SHPT 64% and THPT 16%; at month-12 HPT prevalence was 77% of which SHPT 62% and THPT 15%. A strong significant correlation was found between HPT type, PTH levels and graft loss at every time point. Mean PTH exposure remained strongly and independently associated to long-term graft loss (OR 3.1 [1.4-7.1], p=0.008). THPT was independently associated with graft loss at month-1 when compared to HPT absence and at every time point when compared to SHPT. No correlation was found with RTx-p death. Discriminatory analyses identified the best mean PTH cut-off to predict long-term graft loss to be between 88.6 and 89.9 pg/ml (AUC=0.658). Cox regression analyses highlighted that THPT was strongly associated with shorter long-term graft survival at every time point considered (Figure 1, PTH status at 12-months after KTx).

Conclusion

High PTH levels, and especially tertiary HPT during 1st year of RTx seem to be associated with long-term graft loss.

Survival analyses of long-term graft outcomes according to PTH status at 12-months after KTx