Results of heterotopic parathyroid autotransplantation

A 13-year experience

Andrew L. Feldman, Renu N. Sharaf, Monica C. Skarulis, David L. Bartlett, Steven K. Libutti, Lee S. Weinstein, Stephen J. Marx, Jeffrey A. Norton, Douglas L. Fraker, H. Richard Alexander

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background. The reported success of heterotopic parathyroid autotransplantation (HPA) in patients with primary hyperparathyroidism varies from 20% to 60%. The purpose of this study was to evaluate our results with HPA to help define its role in this patient group. Methods. Between July 1985 and June 1998, 44 patients underwent 51 HPA procedures at our institution. Twenty to 25 fragments of parathyroid tissue measuring 1 to 3 mm3 each were placed into the forearm musculature. HPA results were scored as nonfunctional (requiring calcium and vitamin D), partially functional (normocalcemia on calcium alone), fully functional (normocalcemia without supplementation), or hyperfunctional (hypercalcemia without supplementation). Results. Follow-up data were available for 39 patients who underwent 46 autografts (20 immediate and 26 cryopreserved). With a median follow-up of 35 months, 19 autografts (41%) were nonfunctional; 9 autografts (20%) were partially functional; 15 autografts (33%) were fully functional, and 3 autografts (7%) were hyperfunctional. Full function was observed in 35% of immediate and 31% of delayed autografts. Conclusions. One third of parathyroid autografts develop full function, and an additional one fifth develop partial function. Recurrent hyperparathyroidism is uncommon. No benefit was observed from immediate versus delayed HPA, and the modest success rate of HPA suggests that improvements in technique are warranted.

Original languageEnglish (US)
Pages (from-to)1042-1048
Number of pages7
JournalSurgery
Volume126
Issue number6
DOIs
StatePublished - 1999
Externally publishedYes

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Autologous Transplantation
Autografts
Calcium
Primary Hyperparathyroidism
Hyperparathyroidism
Hypercalcemia
Forearm
Vitamin D

ASJC Scopus subject areas

  • Surgery

Cite this

Feldman, A. L., Sharaf, R. N., Skarulis, M. C., Bartlett, D. L., Libutti, S. K., Weinstein, L. S., ... Alexander, H. R. (1999). Results of heterotopic parathyroid autotransplantation: A 13-year experience. Surgery, 126(6), 1042-1048. https://doi.org/10.1067/msy.2099.101580

Results of heterotopic parathyroid autotransplantation : A 13-year experience. / Feldman, Andrew L.; Sharaf, Renu N.; Skarulis, Monica C.; Bartlett, David L.; Libutti, Steven K.; Weinstein, Lee S.; Marx, Stephen J.; Norton, Jeffrey A.; Fraker, Douglas L.; Alexander, H. Richard.

In: Surgery, Vol. 126, No. 6, 1999, p. 1042-1048.

Research output: Contribution to journalArticle

Feldman, AL, Sharaf, RN, Skarulis, MC, Bartlett, DL, Libutti, SK, Weinstein, LS, Marx, SJ, Norton, JA, Fraker, DL & Alexander, HR 1999, 'Results of heterotopic parathyroid autotransplantation: A 13-year experience', Surgery, vol. 126, no. 6, pp. 1042-1048. https://doi.org/10.1067/msy.2099.101580
Feldman AL, Sharaf RN, Skarulis MC, Bartlett DL, Libutti SK, Weinstein LS et al. Results of heterotopic parathyroid autotransplantation: A 13-year experience. Surgery. 1999;126(6):1042-1048. https://doi.org/10.1067/msy.2099.101580
Feldman, Andrew L. ; Sharaf, Renu N. ; Skarulis, Monica C. ; Bartlett, David L. ; Libutti, Steven K. ; Weinstein, Lee S. ; Marx, Stephen J. ; Norton, Jeffrey A. ; Fraker, Douglas L. ; Alexander, H. Richard. / Results of heterotopic parathyroid autotransplantation : A 13-year experience. In: Surgery. 1999 ; Vol. 126, No. 6. pp. 1042-1048.
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abstract = "Background. The reported success of heterotopic parathyroid autotransplantation (HPA) in patients with primary hyperparathyroidism varies from 20{\%} to 60{\%}. The purpose of this study was to evaluate our results with HPA to help define its role in this patient group. Methods. Between July 1985 and June 1998, 44 patients underwent 51 HPA procedures at our institution. Twenty to 25 fragments of parathyroid tissue measuring 1 to 3 mm3 each were placed into the forearm musculature. HPA results were scored as nonfunctional (requiring calcium and vitamin D), partially functional (normocalcemia on calcium alone), fully functional (normocalcemia without supplementation), or hyperfunctional (hypercalcemia without supplementation). Results. Follow-up data were available for 39 patients who underwent 46 autografts (20 immediate and 26 cryopreserved). With a median follow-up of 35 months, 19 autografts (41{\%}) were nonfunctional; 9 autografts (20{\%}) were partially functional; 15 autografts (33{\%}) were fully functional, and 3 autografts (7{\%}) were hyperfunctional. Full function was observed in 35{\%} of immediate and 31{\%} of delayed autografts. Conclusions. One third of parathyroid autografts develop full function, and an additional one fifth develop partial function. Recurrent hyperparathyroidism is uncommon. No benefit was observed from immediate versus delayed HPA, and the modest success rate of HPA suggests that improvements in technique are warranted.",
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