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Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
Hemolysis falsely decreases intraoperative parathyroid hormone levels
Jacob Moalem1, Daniel T Ruan, Rachel L Farkas
1University of California, San Francisco, CA, USA. jacob_moalem@urmc.rochester.edu
American Journal of Surgery
|December 20, 2008
Summary
Hemolysis of intraoperative parathyroid hormone (IOPTH) samples is common and falsely lowers IOPTH levels. This can lead to incorrect surgical decisions during parathyroidectomy, such as unnecessary exploration or failed procedures.
Area of Science:
- Endocrinology
- Surgical Pathology
- Clinical Chemistry
Background:
- Intraoperative parathyroid hormone (IOPTH) measurement is crucial for confirming biochemical cure during parathyroidectomy.
- Inaccurate IOPTH levels can lead to false-negative or false-positive results, potentially causing surgical failure or unnecessary interventions.
Purpose of the Study:
- To determine the frequency of hemolysis in intraoperative parathyroid hormone (IOPTH) samples during parathyroidectomy.
- To assess the impact of hemolysis on IOPTH measurements and its clinical implications.
Main Methods:
- Retrospective review of patient records undergoing parathyroidectomy with IOPTH measurement (May-August 2007).
- Determination of hemolysis frequency in collected IOPTH samples.
- Laboratory analysis of split-samples subjected to freeze-thaw hemolysis.
Main Results:
- Out of 226 IOPTH samples from 47 patients, 7.5% (17 specimens) from 18.8% (9 patients) showed hemolysis.
- In split-sample testing, hemolysis caused a decrease in IOPTH levels ranging from 24.5% to 53.8% compared to non-hemolyzed controls.
Conclusions:
- Hemolysis of IOPTH samples is a frequent occurrence in clinical practice.
- Unrecognized hemolysis can lead to erroneous IOPTH results, potentially causing unnecessary continued exploration or failed parathyroidectomy requiring reoperation.
- Preventing sample hemolysis is essential for accurate IOPTH measurements and successful parathyroidectomy outcomes.
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