PARATHYROID AUTOTRANSPLANTATION

Objective: To summarize the indications and techniques for parathyroid autotransplantation and to explore other aspects of the field that warrant further research and discussion. Methods: Review of relevant literature with focus on parathyroid autotransplantation and cryopreservation. Results: Parathyroid autotransplantation is an important technique used by surgeons to circumvent postoperative hypoparathyroidism. Immediate autotransplantation is used intraoperatively, most commonly in the setting of total thyroidectomy or during total parathyroidectomy in a patient with parathyroid hyperplasia. Delayed autotransplantation with cryopreservation is typically used in patients with persistent or recurrent hyperparathyroidism who require repeated cervical exploration. Conclusions: The success rate of autotransplantation in preventing postoperative hypoparathyroidism reported in the literature is highly variable and is dependent on timing, disease, and duration of tissue storage. Ultimately, surgical planning for patients with hyperparathyroidism involves finding a balance between decreasing a patient's symptoms, increasing the time of eucalcemia, and avoiding the complications of permanent hypoparathyroidism.