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Deferred Parathyroid Autografts With Cryopreserved Tissue After Reoperative Parathyroid Surgery

Deferred Parathyroid Autografts With Cryopreserved Tissue After Reoperative Parathyroid Surgery Abstract • Between August 1975 and March 1981, 12 patients underwent forearm parathyroid autotransplantation with cryopreserved tissue following reoperative parathyroid surgery. Tissue had been cryopreserved two to 18 months. Follow-up ranged from four to 66 months (median, 18 months) following autotransplantation. All patients required calcium supplementation as a condition for autografting; six patients were no longer receiving calcium supplementation at most recent follow-up and in one patient the dosage was being tapered. The presence of a parathyroid hormone gradient of 2:1 or greater correlated well with freedom from calcium supplementation. Of seven patients with preautograft and postautograft urinary cyclic adenosine monophosphate (cAMP) determinations, three with increases following transplantation did not require calcium, three without increases continued to require calcium, and the patient whose dosage was being tapered had increased urinary cAMP levels. (Arch Surg 1982;117:538-543) References 1. Edis AJ, VanHeerden JA, Scholz DA: Results of subtotal parathyroidectomy for primary chief cell hyperplasia . Surgery 1979;86:462-469. 2. Wang CA: Parathyroid re-exploration: A clinical and pathological study of 112 cases . Ann Surg 1977;186:140-145.Crossref 3. Edis AJ, Sheedy PF, Beahrs O, et al: Results of reoperation for hyperparathyroidism, with evaluation of preoperative localization studies . Surgery 1978;84:384-393. 4. Saxe AW, Brennan MF: Strategy and technique of reoperative parathyroid surgery . Surgery 1981;89:417-423. 5. Brennan MF, Brown EM, Spiegel AM, et al: Autotransplantation of cryopreserved parathyroid tissue in man . Ann Surg 1979;189:139-142.Crossref 6. Marx SJ, Speigel AM, Brown EM, et al: Circulating parathyroid hormone activity: Familial hypocalciuric hypercalcemia vs. typical primary hyperparathyroidism . J Clin Endocrinol Metab 1978;47:1190-1197.Crossref 7. Marx SJ, Sharp ME, Krudy A, et al: Radioimmunoassay for the middle region of human parathyroid hormone: Studies with a radioiodinated synthetic peptide . J Clin Endocrinol Metab 1981;53:76-84.Crossref 8. Broadus AE, Mahaffey JE, Bartter FC, et al: Nephrogenous cyclic adenosine monophosphate as a parathyroid function test . J Clin Invest 1977;60:771-783.Crossref 9. Brooker G, Terasaki WL, Price MG: Gammaflo: A completely automated radioimmunoassay system . Science 1976;194:270-276.Crossref 10. Halsted WS: Hypoparathyreosis, status parathyroprivous, and transplantation of the parathyroid glands . Am J Med Sci 1907;134:1-12.Crossref 11. Alveryd A: Parathyroid glands in thyroid surgery . Acta Chir Scand Suppl 1968;389. 12. Salander H, Tisell LE: Incidence of hypoparathyroidism after radical surgery for thyroid carcinoma and autotransplantation of parathyroid glands . Am J Surg 1977;134:358-362.Crossref 13. Paloyan E, Lawrence AM, Brooks MH, et al: Total thyroidectomy in parathyroid autotransplantation for radiation-associated thyroid cancer . Surgery 1976;80:70-76. 14. Wilson RE, in discussion, Paloyan E, Lawrence AM, Brooks MH, et al: Total thyroidectomy in parathyroid autotransplantation for radiation-associated thyroid cancer . Surgery 1976;80:75-76. 15. Gann DS, Paone JF: Delayed hypocalcemia after thyroidectomy for Graves' disease is prevented by parathyroid autotransplantation . Ann Surg 1979;190:508-513.Crossref 16. Wells SA, Farndon JR, Dale JK, et al: Long-term evaluation of patients with primary parathyroid hyperplasia managed by total parathyroidectomy and heterotopic autotransplantation . Ann Surg 1980;192:451-458.Crossref 17. Edis AJ, Linos DA, Kao PC: Parathyroid autotransplantation at the time of reoperation for persistent hyperparathyroidism . Surgery 1980; 88:588-593. 18. Saxe AW, Brennan MF: Reoperation for primary hyperparathyroidism due to multiple gland disease: Results of total parathyroidectomy and deferred autotransplantation with cryopreserved tissue. Read before the first annual meeting of the American Society for Endocrine Surgery, Ann Arbor, Mich, May 5 to 6, 1980. 19. Brennan MF, Brown EM, Marx SJ, et al: Recurrent hyperparathyroidism from an autotransplanted parathyroid . N Engl J Med 1978; 299:1057-1059.Crossref 20. Haase GM, Luce JM, Lock JP, et al: Hyperparathyroidism following parathyroid autotransplantation . Surgery 1979;86:694-697. 21. Salander H, Tisell LE: Latent hypoparathyroidism in patients with autotransplanted parathyroid glands . Am J Surg 1980;139:385-388.Crossref 22. Ohman U, Granberg PO, Lindell B: Function of the parathyroid glands after total thyroidectomy . Surg Gynecol Obstet 1978;146:773-778. 23. Paloyan E, Lawrence AM, Paloyan D: Successful autotransplantation of the parathyroid glands during total thyroidectomy for carcinoma . Surg Gynecol Obstet 1977;145:364-368. 24. Brennan MF, Doppman JL, Marx SJ, et al: Reoperative parathyroid surgery for persistent hyperparathyroidism . Surgery 1978;83:669-676. 25. Cordell LJ, Maxwell JG, Warden GD: Parathyroidectomy in chronic renal failure . Am J Surg 1979;138:951-956.Crossref 26. Diethelm AG, Adams PL, Murad TM, et al: Treatment of secondary hyperparathyroidism in patients with chronic renal failure by total parathyroidectomy and parathyroid autograft . Ann Surg 1981;193:777-793.Crossref 27. Frei U, Fassbinder W, Klempa I, et al: Total parathyroidectomy with autograft of parathyroid tissue in treatment of secondary hyperparathyroidism , in Robinson BHB, Hawkins JB (eds): Dialysis Transplantation Nephrology . Tunbridge Wells, England, Pitman Medical Publishing Co Ltd, 1978. 28. Hickey RC, Samaan NA: Human parathyroid autotransplantation. Proved function by radioimmunoassay of plasma parathyroid hormone . Arch Surg 1975;110:892-895.Crossref 29. Lundgren G, Asaba M, Magnusson G, et al: The role of parathyroidectomy in the treatment of secondary hyperparathyroidism before and after renal transplantation . Scand J Urol Nephrol 1977;42:149-152. 30. Lundstrom B, Anderberg B, Gillquist J: Clinical experience of parathyroid autotransplantation . Acta Chir Scand 1978;144:451-453. 31. Max MH, Flint LM, Richardson JD, et al: Total parathyroidectomy and parathyroid autotransplantation in patients with chronic renal failure . Surg Gynecol Obstet 1981;153:177-180. 32. Mozes MF, Soper WD, Jonasson O, et al: Total parathyroidectomy and autotransplantation in secondary hyperparathyroidism . Arch Surg 1980; 115:378-385.Crossref 33. Sicard GA, Anderson CB, Hruska K: Parathormone levels after subtotal and total (autotransplantation) parathyroidectomy for secondary hyperparathyroidism . J Surg Res 1980;29:541-545.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Deferred Parathyroid Autografts With Cryopreserved Tissue After Reoperative Parathyroid Surgery

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1982.01380290010003
Publisher site
See Article on Publisher Site

Abstract

Abstract • Between August 1975 and March 1981, 12 patients underwent forearm parathyroid autotransplantation with cryopreserved tissue following reoperative parathyroid surgery. Tissue had been cryopreserved two to 18 months. Follow-up ranged from four to 66 months (median, 18 months) following autotransplantation. All patients required calcium supplementation as a condition for autografting; six patients were no longer receiving calcium supplementation at most recent follow-up and in one patient the dosage was being tapered. The presence of a parathyroid hormone gradient of 2:1 or greater correlated well with freedom from calcium supplementation. Of seven patients with preautograft and postautograft urinary cyclic adenosine monophosphate (cAMP) determinations, three with increases following transplantation did not require calcium, three without increases continued to require calcium, and the patient whose dosage was being tapered had increased urinary cAMP levels. (Arch Surg 1982;117:538-543) References 1. Edis AJ, VanHeerden JA, Scholz DA: Results of subtotal parathyroidectomy for primary chief cell hyperplasia . Surgery 1979;86:462-469. 2. Wang CA: Parathyroid re-exploration: A clinical and pathological study of 112 cases . Ann Surg 1977;186:140-145.Crossref 3. Edis AJ, Sheedy PF, Beahrs O, et al: Results of reoperation for hyperparathyroidism, with evaluation of preoperative localization studies . Surgery 1978;84:384-393. 4. Saxe AW, Brennan MF: Strategy and technique of reoperative parathyroid surgery . Surgery 1981;89:417-423. 5. Brennan MF, Brown EM, Spiegel AM, et al: Autotransplantation of cryopreserved parathyroid tissue in man . Ann Surg 1979;189:139-142.Crossref 6. Marx SJ, Speigel AM, Brown EM, et al: Circulating parathyroid hormone activity: Familial hypocalciuric hypercalcemia vs. typical primary hyperparathyroidism . J Clin Endocrinol Metab 1978;47:1190-1197.Crossref 7. Marx SJ, Sharp ME, Krudy A, et al: Radioimmunoassay for the middle region of human parathyroid hormone: Studies with a radioiodinated synthetic peptide . J Clin Endocrinol Metab 1981;53:76-84.Crossref 8. Broadus AE, Mahaffey JE, Bartter FC, et al: Nephrogenous cyclic adenosine monophosphate as a parathyroid function test . J Clin Invest 1977;60:771-783.Crossref 9. Brooker G, Terasaki WL, Price MG: Gammaflo: A completely automated radioimmunoassay system . Science 1976;194:270-276.Crossref 10. Halsted WS: Hypoparathyreosis, status parathyroprivous, and transplantation of the parathyroid glands . Am J Med Sci 1907;134:1-12.Crossref 11. Alveryd A: Parathyroid glands in thyroid surgery . Acta Chir Scand Suppl 1968;389. 12. Salander H, Tisell LE: Incidence of hypoparathyroidism after radical surgery for thyroid carcinoma and autotransplantation of parathyroid glands . Am J Surg 1977;134:358-362.Crossref 13. Paloyan E, Lawrence AM, Brooks MH, et al: Total thyroidectomy in parathyroid autotransplantation for radiation-associated thyroid cancer . Surgery 1976;80:70-76. 14. Wilson RE, in discussion, Paloyan E, Lawrence AM, Brooks MH, et al: Total thyroidectomy in parathyroid autotransplantation for radiation-associated thyroid cancer . Surgery 1976;80:75-76. 15. Gann DS, Paone JF: Delayed hypocalcemia after thyroidectomy for Graves' disease is prevented by parathyroid autotransplantation . Ann Surg 1979;190:508-513.Crossref 16. Wells SA, Farndon JR, Dale JK, et al: Long-term evaluation of patients with primary parathyroid hyperplasia managed by total parathyroidectomy and heterotopic autotransplantation . Ann Surg 1980;192:451-458.Crossref 17. Edis AJ, Linos DA, Kao PC: Parathyroid autotransplantation at the time of reoperation for persistent hyperparathyroidism . Surgery 1980; 88:588-593. 18. Saxe AW, Brennan MF: Reoperation for primary hyperparathyroidism due to multiple gland disease: Results of total parathyroidectomy and deferred autotransplantation with cryopreserved tissue. Read before the first annual meeting of the American Society for Endocrine Surgery, Ann Arbor, Mich, May 5 to 6, 1980. 19. Brennan MF, Brown EM, Marx SJ, et al: Recurrent hyperparathyroidism from an autotransplanted parathyroid . N Engl J Med 1978; 299:1057-1059.Crossref 20. Haase GM, Luce JM, Lock JP, et al: Hyperparathyroidism following parathyroid autotransplantation . Surgery 1979;86:694-697. 21. Salander H, Tisell LE: Latent hypoparathyroidism in patients with autotransplanted parathyroid glands . Am J Surg 1980;139:385-388.Crossref 22. Ohman U, Granberg PO, Lindell B: Function of the parathyroid glands after total thyroidectomy . Surg Gynecol Obstet 1978;146:773-778. 23. Paloyan E, Lawrence AM, Paloyan D: Successful autotransplantation of the parathyroid glands during total thyroidectomy for carcinoma . Surg Gynecol Obstet 1977;145:364-368. 24. Brennan MF, Doppman JL, Marx SJ, et al: Reoperative parathyroid surgery for persistent hyperparathyroidism . Surgery 1978;83:669-676. 25. Cordell LJ, Maxwell JG, Warden GD: Parathyroidectomy in chronic renal failure . Am J Surg 1979;138:951-956.Crossref 26. Diethelm AG, Adams PL, Murad TM, et al: Treatment of secondary hyperparathyroidism in patients with chronic renal failure by total parathyroidectomy and parathyroid autograft . Ann Surg 1981;193:777-793.Crossref 27. Frei U, Fassbinder W, Klempa I, et al: Total parathyroidectomy with autograft of parathyroid tissue in treatment of secondary hyperparathyroidism , in Robinson BHB, Hawkins JB (eds): Dialysis Transplantation Nephrology . Tunbridge Wells, England, Pitman Medical Publishing Co Ltd, 1978. 28. Hickey RC, Samaan NA: Human parathyroid autotransplantation. Proved function by radioimmunoassay of plasma parathyroid hormone . Arch Surg 1975;110:892-895.Crossref 29. Lundgren G, Asaba M, Magnusson G, et al: The role of parathyroidectomy in the treatment of secondary hyperparathyroidism before and after renal transplantation . Scand J Urol Nephrol 1977;42:149-152. 30. Lundstrom B, Anderberg B, Gillquist J: Clinical experience of parathyroid autotransplantation . Acta Chir Scand 1978;144:451-453. 31. Max MH, Flint LM, Richardson JD, et al: Total parathyroidectomy and parathyroid autotransplantation in patients with chronic renal failure . Surg Gynecol Obstet 1981;153:177-180. 32. Mozes MF, Soper WD, Jonasson O, et al: Total parathyroidectomy and autotransplantation in secondary hyperparathyroidism . Arch Surg 1980; 115:378-385.Crossref 33. Sicard GA, Anderson CB, Hruska K: Parathormone levels after subtotal and total (autotransplantation) parathyroidectomy for secondary hyperparathyroidism . J Surg Res 1980;29:541-545.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1982

References