Evaluating Recovery After Parathyroid Cell Transplantation Using a Novel Scoring System.

Abstract

Objectives: Permanent hypoparathyroidism is a lifelong condition and characterized by chronic hypocalcemia and dependence on calcium and active vitamin D therapy. Parathyroid cell transplantation has emerged as a potential restorative treatment, yet standardized tools for assessment of posttransplant recovery are lacking. This study aimed to evaluate clinical recovery following parathyroid cell transplant using a novel functional scoring system.

Materials and methods: This retrospective, single -center (in Istanbul, Türkiye ), longitudinal study included 40 consecutive parathyroid cell transplants performed between 2019 and 2024 in patients with permanent hypoparathyroidism. A 5 -level recovery scoring system (score 0 to 4 ) integrating serum calcium levels, medication requirements, and hypocalcemia -related symptoms was developed to assess outcomes. Patients were followed for up to 4 years. Clinically meaningful recovery was defined as score ≥3, corresponding to a ≥50 % reduction in calcium and/or active vitamin D supplementation.

Results: Recovery scores improved progressively over time posttransplant. Most patients demonstrated early biochemical benefit within the first 2 months, followed by stabilization and sustained improvement. By 6 months, a substantial proportion achieved clinically meaningful recovery (score ≥3 ), characterized by marked reduction in supplementation requirements and symptomatic improvement. A limited subset of patients achieved score 4, indicating complete independence from replacement therapy. Serum calcium levels showed a significant time -dependent increase, although interindividual variability in response persisted.

Conclusions: Parathyroid cell transplant can provide sustained functional improvement in patients with permanent hypoparathyroidism. The proposed recovery scoring system offers a practical, clinically meaningful tool that integrates biochemical parameters, medication dependence, and symptoms, enabling standardized monitoring of posttransplant outcomes. This approach may facilitate long -term treatment management strategies for this challenging disease.