Thyroid and Parathyroid Dysfunction Following Larynx-Trachea-Thyroid-Parathyroid Allotransplantation

Larynx-trachea-thyroid-parathyroid allotransplantation can restore essential laryngeal functions, but postoperative endocrine changes remain poorly understood. This study assessed thyroid and parathyroid function in four recipients. All developed early thyroid hormone alterations consistent with euthyroid sick syndrome, followed by variable endocrine outcomes. Two experienced thyrotoxicosis associated temporally with graft rejection, while another developed hypothyroidism and elevated parathyroid hormone during late rejection. Transient parathyroid hormone suppression was also observed. In contrast, the recipient without rejection maintained stable endocrine function. These findings suggest that endocrine changes may accompany graft rejection, although causality remains unestablished. Serial endocrine monitoring may complement conventional rejection surveillance but should not be used independently to diagnose rejection. Larger studies with longer follow-up are needed to clarify the clinical significance of these findings.