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Autografts of normal and hyperplastic human parathyroid: Experience in eleven patients with immunoassay monitoring of function in seven

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Abstract

Parathyroid autografts were implanted in 11 patients at this institution. Four patients had total or subtotal parathyroidectomy and implantation for parathyroid hyperplasia or adenoma, while 7 had one or more parathyroids removed and implanted during total thyroidectomy for carcinoma of the thyroid. Hyperplastic parathyroid was implanted in 4 instances and normal parathyroid in 7. Recurrent hyperparathyroidism occurred in 1 patient with an implanted adenoma who was returned to a normocalcemic state by partial reexcision (“titration”) of the implanted tissue.

All implants were placed in muscle pockets, a single site being used for patients receiving normal parathyroid tissue, and multiple sites for patients receiving hyperplastic glands. Those patients receiving forearm implants were followed up by serial parathyroid hormone determinations in venous blood drawn from both arms. In all cases, elevated levels were found on the implanted side, as compared to the contralateral control side.

Résumé

L'autotransplantation des parathyroïdes a été réalisée chez ll malades: 4 avaient subi une parathyroïdectomie totale ou subtotale pour hyperplasie ou adénome parathyroïdien; chez les 7 autres, une ou plusieurs parathyroïdes avaient été enlevées au cours d'une thyroïdectomie totale pour cancer thyroïdien. Le tissu implanté provenait, dans 4 cas de parathyroïdes hyperplasiques et dans 7 cas de parathyroïdes normales. Un malade, chez qui un adénome avait été implanté, a présenté une récidive d'hyperparathyroïdie; sa calcémie est redevenue normale après excision partielle (“titration”) du tissu implanté.

Tous les implants ont été placés dans des logettes musculaires, au niveau d'un seul site lorsque le tissu transplanté était de la parathyroïde normale, en plusieurs sites pour les implantations de parathyroïdes hyperplasiques. Les malades avec implant au niveau de l'avant-bras ont été suivis par dosage de la parathormone dans le sang veineux des 2 bras. Dans tous les cas, les taux étaient plus élevés du côté portant les implants.

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Authors and Affiliations

  1. Department of Surgery, M.D. Anderson Hospital and Tumor Institute, Texas Medical Center, 77030, Houston, Texas, U.S.A.

    John H. Raaf M.D., Ph.D., Naguib Samaan M.D., Ph.D. & Robert C. Hickey M.D.

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  1. John H. Raaf M.D., Ph.D.
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  2. Naguib Samaan M.D., Ph.D.
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  3. Robert C. Hickey M.D.
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Additional information

Supported by Grants CA-05831-17 (NCI), CA16672-04 (NCI), and ACS PDT-41F (American Cancer Society).

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Raaf, J.H., Samaan, N. & Hickey, R.C. Autografts of normal and hyperplastic human parathyroid: Experience in eleven patients with immunoassay monitoring of function in seven. World J. Surg. 4, 209–218 (1980). https://doi.org/10.1007/BF02393579

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