A Prospective Study of the Factors Related to the Survival of Autologous Parathyroid Gland Left Brachioradialis Transplantation: A Single-Center Study and Long-Term Follow-Up

Deguang Zhang*

Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, China

^*Correspondance to: Deguang Zhang 

 PDF  Full Text DOI: 10.25107/2474-1647.3524

Abstract

Parathyroid gland transplantation into the sternocleidomastoid muscle is effective, but it is not possible to confirm transplant survival with this method. In this study, we evaluated parathyroid autotransplantation into the brachioradialis muscle and evaluated the factors associated with short- (up to 6 months) and long-term survival (up to 3 years). Objectives: To evaluate autologous parathyroid gland left forearm brachioradialis muscle transplantation and analyze the factors related to transplant survival. Methods: We followed-up patients who underwent thyroidectomy and autologous parathyroid left forearm brachioradialis muscle transplantation in our center from September 2013 to January 2018. All enrolled patients underwent at least 3 years of follow-up. We calculated the transplant survival rate at several time points and analyzed the factors related to survival. Results: We evaluated 238 transplanted cases, for which the long-term survival rate was 85.7% (204/238), and the short-term survival rate was 86.1% (205/238). Sixty-five cases had two parathyroid glands transplanted into the left forearm brachioradialis muscle. The long-term survival rate was 92.3% (60/65), and the short-term survival rate was 95.4% (62/65). Survival was not related to age, sex, surgical method, preoperative hemoglobin, preoperative albumin, diabetes, hypertension, preoperative parathyroid hormone concentration, or preoperative serum calcium. The lowest serum calcium within 48 hours after surgery may be an independent predictor of transplant survival; lower serum calcium was associated with higher survival probability. However, the difference in serum calcium values between patients with not- vs. long-term parathyroid gland transplant survival was small, and further research is needed. Conclusion: The lowest serum calcium concentration within 48 h after surgery may predict transplant survival. We recommend appropriate calcium supplementation. The word “appropriate” does not refer to the specific blood calcium value, but rather to supplementation according to the patient’s symptoms, and to supplementing as little as possible or even not at all.

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Cite the article

Zhang D. A Prospective Study of the Factors Related to the Survival of Autologous Parathyroid Gland Left Brachioradialis Transplantation: A Single-Center Study and Long-Term Follow-Up. Clin Surg. 2022; 7: 3524.