The current role of parathyroid cryopreservation and autotransplantation in parathyroid surgery: an institutional experience

Surgery
J A CaccitoloS Sterioff

Abstract

Hypoparathyroidism after cervical exploration is a rare but problematic complication. Cryopreservation and subsequent autotransplantation of parathyroid tissue are infrequently used to combat this problem; effective usage of this surgical adjunct remains variable. From 1981 through 1995 we performed 3080 cervical explorations for hyperparathyroidism. Cryopreservation was performed in 112 (3.6%) patients. This review evaluates our indications and usage of cryopreservation and autotransplantation and the eventual outcome after autotransplantation. Of 81 women and 31 men, 106 (95%) had undergone previous exploration for hyperparathyroidism or thyroid disease. The primary indication for cryopreservation was uncertainty about the viability and number of remaining parathyroid glands. After operation 23 patients (20%) were permanently hypocalcemic and became autotransplantation candidates. Thirteen patients underwent a total of 15 autotransplantations (median postoperative interval, 7 months). Although 6 of 15 grafts (40%) were shown to secrete parathyroid hormone, only three patients (23%) were normocalcemic without supplemental therapy. Cryopreservation with autotransplantation is in theory a sound but difficult practice to correct ...Continue Reading

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