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Parathyroidectomy is the only cure for primary hyperparathyroidism and is effective in more than 95% of cases at initial surgical intervention. However, 2.5-5% of cases have recurrent or persistent disease. Pre-operative imaging is recommended in patients undergoing redo parathyroidectomy to localize the diseased gland. Parathyroid 4D CT scan is now widely used for localization and has been reported to have improved accuracy when compared to other imaging modalities. We conducted a retrospective study of all redo parathyroidectomies from 2017 to 2021 at a single tertiary parathyroid referral center. We evaluated pre-operative 4D CT scan results and compared them to intra-operative findings to determine if 4D CT scan correctly predicted the location of the diseased gland. 4D CT scan had a concordance of 87% with intra-operative findings. 4D CT scan is highly effective identifying parathyroid pathology in re-operative cases and can be used as a pre-operative tool to guide surgical management.

Introduction: The Kidney Allocation System (KAS) implemented on December 4, 2014, was expected to improve kidney transplant list wait-time and allocate more kidney to high cPRA patients. This study aims to demonstrate outcomes after the implementation of the KAS in a Hispanic transplant center. Methods: Retrospective study from a prospectively maintained database from a single-transplant center. Included all DDKT from July 2013 to June 2016. Compare and analyze DDKT selection and outcomes before and after KAS implementation. Results: The overall number of kidney transplants performed during this period was 220. All of the patients were Hispanic. Included 50.5% Pre-KAS and 49.5% Post-KAS. Pre-KAS group had a significantly shorter waiting-time list than the post-KAS group, 900.05 vs 1126.75 respectively. EPTS less than 20% significantly improved in the Post-KAS group compared to the Pre-KAS group, 41.3% vs 20.9% respectively. No differences observed in KDPI, 1-year graft failure, or 1-year mortality rates. Conclusion: This might be the first Hispanic only cohort evaluating the effects of KAS on a moderate volume kidney transplant center. The new system increased the wait-time list by approximately 25%, and it did not improve graft quality, graft failure, or mortality rates.

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