Parathyroid autotransplantation during thyroidectomy - Documentation of graft function

Hypothesis: Biochemical function of normal parathyroid tissue grafted durin g thyroidectomy can be documented. Design: An intervention study in which devascularized or inadvertently remo ved parathyroid glands are reimplanted in forearm muscle pockets during thy roidectomy. Postoperative serum parathyroid hormone levels were evaluated b y venous sampling from both forearms on postoperative days 1, 3, 14, 28, 56 , and 84. Setting: Tertiary care teaching hospital. Patients: Seven patients undergoing thyroidectomy at risk for postoperative hypocalcemia. Results: A 1.5-fold gradient of parathyroid hormone measurements between gr afted and nongrafted arms was demonstrated in all patients on postoperative day 28. A maximal parathyroid hormone gradient was reached on day 56, and biochemical function persisted in 6 patients on day 84. Conclusions: Biochemical function of parathyroid glands reimplanted during thyroidectomy can be demonstrated objectively. The application of parathyro id autotransplantation may preserve parathyroid function for inadvertently removed or devascularized parathyroid glands during thyroid surgery.