Part of “CHAPTER 62 – SURGERY OF THE PARATHYROID GLANDS“

The decision to use immediate versus delayed autografting depends on the potential risk of graft loss during the freezing and thawing process, versus the risk of graft-dependent hypercalcemia. The incidence of graft-dependent hypercalcemia is 30% within 3 months to 2 years after the autografting of fresh hyperfunctioning parathyroid tissue.12 Also, cases of recalcitrant or recurrent graft-dependent hypercalcemia have been reported.31 Whether persistent parathyroid hyperfunction is caused by pathologic tissue left in situ or by the hyperfunctioning graft may be unclear. Assay for forearm PTH levels may aid in this differentiation. For these reasons, some have advocated delayed autografting using in vitro–tested cryopreserved parathyroid tissue.