Twenty-five patients with permanent postoperative
hypoparathyroidism received cryopreserved parathyroid autografts. Twelve patients had undergone cervical re-operations due to persistent or recurrent
hyperparathyroidism and 10 patients had malfunction of a fresh autograft after total
parathyroidectomy.
Hypoparathyroidism occurred in 2 patients after subtotal
parathyroidectomy and in 1 after the resection of a solitary
adenoma following previous thyroid resection. The viability of the tissue was examined histologically prior to
replantation in 22 patients and the amount of tissue needed for
transplantation was determined by the ratio of necrotic cells vs. viable cells in the material. The patients were examined between 6 months and 125 months (median: 40 months) after
replantation. Pre-operatively each patient required high doses of
calcium and
vitamin D metabolites to establish normocalcemia. This medication was reduced postoperatively, with 16 patients requiring no supplemental treatment. Nine patients still needed low doses of
calcium and/or
vitamin D. At follow-up all patients were free of hypocalcemic symptoms. Our results demonstrate that
replantation of autologous cryopreserved parathyroid tissue is safe and effective
therapy for permanent postoperative
hypoparathyroidism. Thus, we regard it as an essential part of today's parathyroid surgery.