PARATHYROID AUTOTRANSPLANTATION IN PATIENTS UNDERGOING A TOTAL THYROIDECTOMY - A REVIEW OF 261 PATIENTS

Parathyroid autotransplantation was first described in 1907 by Halsted . However, this simple and effective method of preserving parathyroid function has been used with increasing frequency only during the past 25 years. Beginning in the late 1960s, our group has transplanted norm al parathyroid tissue into the ipsilateral sternocleidomastoid muscle whenever these glands could not be preserved in situ with adequate blo od supply. In addition, if the blood supply of all four parathyroid gl ands appeared compromised, cryopreservation of parathyroid tissue was performed in case the autotransplanted tissue did not function after s urgery. Since 1970, 393 patients underwent a total thyroidectomy. Para thyroid glands that could not be saved in situ were biopsied to confir m their identity by frozen section and then autotransplanted. Of the 3 93 patients who underwent a total thyroidectomy, 261 patients required transplantation of one or more glands. Among those 261 patients who u nderwent selective parathyroid autotransplantation, 33 (13%) required temporary calcium and vitamin D supplementation. Of these 33 patients, 2 (less than 1%) had permanent hypoparathyroidism and are receiving l ong-term vitamin D therapy.