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The Evidence for and Against Parathyroid Cryopreservation: Should We Continue to Promote Parathyroid Cryopreservation?

  • Selyne Samuel
  • Marlon A. Guerrero
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

Permanent hypoparathyroidism is a rare, yet life-altering complication of thyroid and parathyroid surgery. However, the advent of parathyroid cryopreservation, and subsequent autotransplantation of parathyroid tissue, revolutionized the management of this devastating complication. However, cryopreservation of parathyroid tissue is not widely performed due to the rarity of utilization, the potential high costs, and need for specialized expertise. Furthermore, studies have shown that the viability of the parathyroid tissue is diminished after 2 years, raising more debate about need for cryopreservation. In this chapter, we evaluate data justifying and contradicting the practice of parathyroid cryopreservation.

Keywords

Parathyroid Autotransplantation Cryopreservation Hypoparathyroidism Hypocalcemia 

References

  1. 1.
    Flechner SM, Berber E, Askar M, Stephany B, Agarwal A, Milas M. Allotransplantation of cryopreserved parathyroid tissue for severe hypocalcemia in a renal transplant recipient. Am J Transplant. 2010;10:2061–5.CrossRefPubMedGoogle Scholar
  2. 2.
    Larrad Jiménez A, Hernández Hernández JR. Parathyroid transplantation. Endocrinología y Nutrición (English Edition). 2013;60(4):161–3.CrossRefGoogle Scholar
  3. 3.
    Caccitolo JA, Farley DR, van Heerden JA, Grant CS, Thompson GB, Sterioff S. The current role of parathyroid cryopreservation and autotransplantation in parathyroid surgery: an institutional experience. Surgery. 1997;122:1062–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Cohen MS, Dilley WG, Wells SA Jr, et al. Long-term functionality of cryopreserved parathyroid autografts: a 13-year prospective analysis. Surgery. 2005;138:1033–40.CrossRefPubMedGoogle Scholar
  5. 5.
    Guerrero MA. Cryopreservation of parathyroid glands. Int J Endocrinol. 2010.Google Scholar
  6. 6.
    Wells SA Jr, Ellis GJ, Gunnells JC, et al. Parathyroid autotransplantation in primary parathyroid hyperplasia. N Engl J Med. 1976;295:57–62.CrossRefPubMedGoogle Scholar
  7. 7.
    Wells SA Jr, Farndon JR, Dale JK, Leight GS, Dilley WG. Long-term evaluation of patients with primary parathyroid hyperplasia managed by total parathyroidectomy and heterotopic autotransplantation. Ann Surg. 1980;192:451–8.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Agarwal A, Waghray A, Gupta S, Sharma R, Milas M. Cryopreservation of parathyroid tissue: an illustrated technique using the Cleveland Clinic protocol. J Am Coll Surg. 2013;216(1):e1–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Schneider R, Ramaswamy A, Slater EP, Bartsch DK, Schlosser K. Cryopreservation of parathyroid tissue after parathyroid surgery for renal hyperparathyroidism: does it really make sense? World J Surg. 2012;36(11):2598–604.CrossRefPubMedGoogle Scholar
  10. 10.
    Herrera M, Grant C, van Heerden JA, Fitzpatrick LA. Parathyroid autotransplantation. Arch Surg. 1992;127:825–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Saxe AW, Spiegel AM, Marx SJ, Brenman MF. Deferred parathyroid autografts with cryopreserved tissue after reoperative parathyroid surgery. Arch Surg. 1982;117(5):538–43.CrossRefPubMedGoogle Scholar
  12. 12.
    Brennan MF, Brown EM, Sears HF, Aurbach GD. Human parathyroid cryopreservation: in vitro testing of function by parathyroid hormone release. Ann Surg. 1978;187(1):87–90.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Guerrero MA, Evans DB, Lee JE, et al. Viability of cryopreserved parathyroid tissue: when is continued storage versus disposal indicated? World J Surg. 2008;32:836–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Wagner PK, Seesko HG, Rothmund M. Replantation of cryopreserved human parathyroid tissue. World J Surg. 1991;15(6):751–5.CrossRefPubMedGoogle Scholar
  15. 15.
    Feldman AL, Sharaf RN, Skarulis MC, et al. Results of heterotopic parathyroid autotransplantation: a 13-year experience. Surgery. 1999;126:1042–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Saxe A. Parathyroid transplantation: a review. Surgery. 1984;95:507–26.PubMedGoogle Scholar
  17. 17.
    Wagner PK, Rumpelt HJ, Krause U, Rothmund M. The effect of cryopreservation on hormone secretion in vitro and morphology of human parathyroid tissue. Surgery. 1986;99:257–64.PubMedGoogle Scholar
  18. 18.
    Wells SA Jr, Gunnells JC, Shelburne JD. Transplantation of the parathyroid glands in man: clinical indications and results. Surgery. 1975;78:34–44.PubMedGoogle Scholar
  19. 19.
    Borot S, Lapierre V, Carnaille B, Goudet P, Penfornis A. Results of cryopreserved parathyroid autografts: a retrospective multicenter study. Surgery. 2010;147(4):529–35.CrossRefPubMedGoogle Scholar
  20. 20.
    Herrera MF, Grant CS, Van Heerden JA, Jacobsen D, Weaver A, Fitzpatrick LA. The effect of cryopreservation on cell viability and hormone secretion in human parathyroid tissue. Surgery. 1992;112:1096–102.PubMedGoogle Scholar
  21. 21.
    Shepet K, Alhefdhi A, Usedom R, Sippel R, Chen H. Parathyroid cryopreservation after parathyroidectomy: a worthwhile practice? Ann Surg Oncol. 2013;20(7):2256–60.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    U.S. Preventive Services Task Force Ratings. Strength of recommendations and quality of evidence. Guide to clinical preventive services, third edition: periodic updates. Rockville: Agency for Healthcare Research and Quality; 2000–2003.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery, Banner University Medical CenterUniversity of ArizonaTucsonUSA

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