Parathyroid autotransplantation

H. F. Burnett, B. W. Thompson and G. L. Barbour

Autotransplantation of the parathyroid to the forearm has been performed in eight patients following total or subtotal parathyroidectomy. The mass of gland implanted was approximately one half that used in other series. Bilateral simultaneous parathormone levels drawn at three months after autografting several higher levels in the autografted arm in every patient examined. Replacement calcium and vitamin D therapy were withdrawn from two patients within eight months after transplant, and it is anticipated that all patients will be off maintenance at 12 months. Electron and light microscopy of grafted tissue has revealed viable glands with intracellular secretory granules, many mitochondria, and little fat. Indications for autotransplantation include patients with refractory renal osteodystrophy, reoperations for primary hyperparathyroidism, and extensive extirpative cancer surgery of the head and neck.