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Parathyroid autotransplantation during thyroidectomy: documentation of graft function.

HYPOTHESIS
Biochemical function of normal parathyroid tissue grafted during thyroidectomy can be documented.


DESIGN
An intervention study in which devascularized or inadvertently removed parathyroid glands are reimplanted in forearm muscle pockets during thyroidectomy. Postoperative serum parathyroid hormone levels were evaluated by 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 grafted 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 parathyroid autotransplantation may preserve parathyroid function for inadvertently removed or devascularized parathyroid glands during thyroid surgery.