PARATHYROID AUTO-TRANSPLANTATION AT THE TIME OF REOPERATION FOR PERSISTENT HYPERPARATHYROIDISM

  • 1 January 1980
    • journal article
    • research article
    • Vol. 88  (4) , 588-593
Abstract
During the 3 yr period from 1977 through 1979, 12 patients received fresh autografts of hyperfunctioning parathyroid tissue into their forearm musculature at the time of reoperation for persistent or recurrent hyperparathyroidism. All patients were considered to be at high risk of permanent hypoparathyroidism after completion of their reoperative surgery, and parathyroid autotransplantation was undertaken in an attempt to circumvent this serious complication. Seven patients received autografts of adenomas; 5 were grafted with hyperplastic glands. At follow-up 4-35 mo. postoperatively, all 12 patients had functioning grafts, as evidenced either by a higher concentration (1 1/2 times or more) of immunoreactive parathyroid hormone in the antecubital venous effluent draining the grafted arm compared with that of the nongrafted arm or by their ability to maintain a normal serum Ca level after cessation or tapering of replacement therapy. One patient with familial hyperparathyroidism who was hypercalcemic again only 2 mo. after removal of a 1.1 gm intrathyroid parathyroid adenoma at reoperation presumably had persistent rather than recurrent hyperparathyroidism, probably due to hyperfunction of residual hyperplastic parathyroid tissue left in situ in the neck or mediastinum.

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