[Long-term results after implantation of autologous cryopreserved parathyroid tissue]

Autologous cryopreserved parathyroid tissue was implanted into 25 patients (12 men and 12 women, median age 45 [24-75] years, and an 18-month-old child) who after a parathyroidectomy for primary or secondary hyperparathyroidism, had developed permanent postoperative hypoparathyroidism. In 12 of the patients it had developed after a second operation for persisting or recurrent hyperparathyroidism. In ten patients it had occurred after total parathyroidectomy and autologous transplantation of fresh parathyroid tissue, in two patients after subtotal parathyroidectomy and in one patient after excision of a solitary parathyroid adenoma following goitre resection. In 22 patients the state of the tissue to be implanted was examined histologically before implantation after defrosting and any necrosis made up by replacement with more than 20 tissue particles. Re-examination took place a median of 40 [3-120] months postoperatively. The high doses of calcium and vitamin D preparations required preoperatively were reduced stepwise in all patients, completely discontinued in 16. At the time of follow-up nine patients were still receiving low doses of calcium and/or vitamin D. Symptoms of hypocalcaemia disappeared in all patients. Thus implantation of autologous cryopreserved parathyroid tissue is a reliable method for the treatment of permanent postoperative hypoparathyroidism.