Technique and outcome of autotransplanting thyroid tissue after total thyroidectomy for simple multinodular goiters

Abstract

Injection of thyroid tissue suspension is a simple method for thyroid autotransplantation. TSH was elevated in the majority to maintain normal or near normal thyroid hormones. Ten-gram implants showed higher isotope uptake than 5-g, although this difference was not reflected by thyroid hormone profile. The implant seemed to function better with the passage of time from 2 months to 12 months.

Heterotopic thyroid autotransplantation: A preliminary clinical study

“…At the end of 12 month follow‐up, the grafts were fully functioning in 6 of 18 patients (33.3%; with normal FT3, FT4, and TSH, without replacement therapy) compared to 3% in a similar study utilizing the same technique when 10 g of thyroid tissue were implanted (except for routinely using 50 μg/d replacement during the postoperative period in the other study), which was conducted on patients with simple multinodular goiter . This is considered a promising outcome.…”

“…Experimental studies have also confirmed the ability of both freshly autotransplanted and cryopreserved thyroid tissue to regain the euthyroid status in thyroidectomized animals . However, only few clinical trials explored the potentials of thyroid autotransplantation in patients with benign thyroid disorders, with wide discrepancies in their methodologies …”

“…The technique described herein has been previously used for parathyroid autotransplantation, and a similar method of tissue preparation and injection was recently applied in thyroid autotransplantation . Because of their naturally occurring angiogenesis and their high oxygen tension, muscles have been widely and successfully used as sites for parathyroid autotransplantation, and to a lesser extent for pancreatic islets and thyroid autotransplantation . However, it is noteworthy that thyroid hormones were shown to affect muscle growth and regeneration .…”

“…However, a longer follow‐up may be needed to accurately judge the graft responsiveness, where further improvement or deterioration of function is possible. The meaning of the aforementioned terms should be considered when the presented results are compared to similar experimental and clinical studies (Table ) . Interestingly, all the grafts regardless of the clinical/pathological diagnosis were functioning based on the results of isotope scanning at 2 months posttransplantation.…”

“…The concept of endocrinal tissue auto‐transplantation has been largely investigated in the case of parathyroid glands, and to a lesser extent for pancreatic islets . Although both the experimental studies of thyroid autotransplantations and the early case reports of lingual thyroid autotransplantations have shown encouraging results, a very limited number of clinical studies investigated thyroid autotransplantation in adult patients with benign thyroid disorders . Moreover, the discrepancy in the patients' characteristics and thyroid autotransplantation technique in these studies hinders the standardization of thyroid autotransplantation for clinical practice.…”