Parathyroid Allotransplant for Treatment of Hypoparathyroidism

Launched by PETER STOCK · Apr 29, 2025

Keywords

ClinConnect Summary

This clinical trial is investigating whether transplanting parathyroid tissue into the forearm can help people with hypoparathyroidism. Hypoparathyroidism is a condition where the body does not produce enough parathyroid hormone (PTH), which is essential for maintaining normal calcium and phosphorus levels in the blood. The tissue used in this study will come from donors who have passed away. The goal is to see if this transplant can improve PTH levels and help patients better manage their calcium and phosphorus levels.

To participate in this trial, you need to be at least 18 years old and have been diagnosed with hypoparathyroidism. Participants must be able to provide consent and follow study procedures. They should also have been experiencing symptoms related to low calcium levels, despite taking medications like vitamin D or calcium supplements. However, certain health conditions, such as severe heart disease, active infections, or poorly controlled diabetes, may prevent someone from joining the study. If you qualify, you can expect to undergo the transplant procedure and be monitored for its effects on your health. This trial is not yet recruiting participants, but it represents a promising approach to treating a challenging condition.

Gender

ALL

Eligibility criteria

• • Inclusion Criteria Only subjects who meet all of the following criteria are eligible for enrollment.
• • 1. Subjects age 18 or older.
• • 2. Subjects who are able to provide written informed consent and to comply with study procedures.
• • 3. Clinical history and laboratory data compatible with hypoparathyroidism (HypoPT) as defined by hypocalcemia and documented PTH levels below the normal range on two occasions greater than 2 weeks apart and 12 months after surgery, requiring large doses of activated vitamin D and oral calcium (\>1G) daily, or currently on PTH (1-84) injections and with ongoing symptomatology due to hypocalcemia and variable degree of biochemical control
• • 4. No history of immunodeficiency (e.g., opportunistic infections) that could be exacerbated by immunosuppression.
• • 5. Up to date immunizations per the University of California, San Francisco (UCSF) standard of care for organ transplantation, including influenza, pneumococcal, hepatitis B, and tetanus-diptheria
• • Exclusion Criteria Subjects who meet any of the following criteria are not eligible for enrollment
• • 1. Presence of donor specific anti-HLA antibodies detected by Luminex Single Antigen/specificity bead assay including weakly reactive antibodies that would not be detected by a flow cross match
• • 2. Intolerance to any drug that will be used as part of the IS regimen.
• • 3. Poorly controlled diabetes with an A1C of \>8%.
• • 4. Blood Pressure (BP): systolic blood pressure (SBP) \> 140mmHg or DBP \>90 mmHg despite treatment with antihypertensive agents. If the BP is greater than 140/90 chart review and discussion with the patient will be done to establish that BP is in good control.
• • 5. Other exclusion criteria including significant renal or hepatic dysfunction
• • 6. For female subjects: Positive pregnancy test, presently breast-feeding, or unwillingness to use effective contraceptive measures for the duration of the study and 4 months after discontinuation. For male subjects: intent to procreate during the duration of the study or within 4 months after discontinuation or unwillingness to use effective measures of contraception. Oral contraceptives, Norplant®, Depo-Provera®, and barrier devices with spermicide are acceptable contraceptive methods; condoms used alone are not acceptable.
• • 7. Active infection including hepatitis B, hepatitis C, HIV, or tuberculosis (TB). Quantiferon gold assay will be used to determine TB infection.
• • 8. Invasive aspergillus, histoplasmosis, and coccidioidomycosis infection or other opportunistic infection within 1 year prior to study entry.
• • 9. Current malignancy or treated malignancy with estimated recurrence rate \>50% at 5 years, except for completely resected squamous or basal cell carcinoma of the skin
• • 10. Known active alcohol or substance abuse.
• • 11. Active infections (except mild skin and nail fungal infections).
• • 12. Active peptic ulcer disease or gastritis, symptomatic gallstones, or portal hypertension.
• • 13. Use of any investigational agents within 4 weeks of screening or 5 half-lives of the investigational product/ medication, whichever is longer. Investigational products with prolonged invivo effects will require a wash-out period that aligns with the biochemical and physiologic effects of the agent prior to the initiation of this protocol. If the half life of the experimental agent is not known, participation in the study will be addressed with the study team and documented in the study record.
• • 14. Any investigational agents/products that could potentially interfere with the safety and/or efficacy of the procedure being studied will be addressed with the study team and documented in the study record.
• • 15. Administration of live attenuated vaccine(s) within 2 months of enrollment.
• • 16. Any medical condition that, in the opinion of the investigator, will interfere with safe study completion.
• • 17. Positive screen for polyoma (BK) viremia at time of screening.
• • 18. CKD stage 4 or 5
• 19. Severe co-existing cardiac disease, characterized by any one of these conditions:
• • 1. Recent myocardiol infarction (MI) (within 1 year)
• • 2. Evidence of ischemia on functional cardiac exam within the last year. These include persantine thallium stress test and/or coronary angiogram which will be performed in any patient with a history of an MI
• • 3. Left ventricular ejection fraction \< 45%
• • 4. Valvular disease requiring replacement with prosthetic valve
• • 20. Substance use that in the opinion of the investigator would interfere with compliance with the study requirements.
• • 21. Past or current medical problems or findings from medical history, physical examination or laboratory testing that are not listed above, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study.