Thyroid Autotransplantation after Total Thyroidectomy in Benign Thyroid Diseases

Abstract

Background: After achievement of parathyroid autotransplantation, thyroid autotransplantation was presented with goal of preventing or lessening severity of post-thyroidectomy hypothyroidism in noncompliant patients. Goal and objectives: In this research, we intended to evaluate efficacy of autotransplantation of thyroid tissue after total thyroidectomy (TT) in benign thyroid disorders to keep the patient euthyroid with no need for life long hormone replacement therapy. Studied cases and methods:The study included thirty patients with benign thyroid disorders for whom total thyroidectomy was done. Autotransplantation was done by excising an apparently healthy portion weighing about 2-5 gm from the resected thyroid gland after total thyroidectomy and slicing this portion into about 10 small fragments then inserting these fragments into pocket made in the sternomastoid muscle. Follow up process contained measurement of serum levels of T3, T4 and TSH and thyroid scanning by 99mTC-MIBI scintigraphy. Results: Serum calcium level following total thyroidectomy: 28 patients had normal serum calcium level (8.5mg/dl-10.5mg/dl) and only 2 patients developed hypocalcaemia. These 2 patients were advised to take oral calcium to correct hypocalcaemia with regular follow up. Conclusion: Thyroid autotransplantation after total thyroidectomy is effective way to avoid postoperative hypothyroidism in benign thyroid disorders.

Cryopreserved Thyroid Tissue Autotransplant in Pediatric Age Patients: A Feasibility Study and Literature Review

“…Studies in humans have been collected in Table 2 for a total of 25 publications ranging from 1938 to date [ 3 , 69 ]. Also, these reports were clustered according to their geographical distribution.…”

“…The studies entailed patients affected by benign thyroid disease. Specifically, thirteen studies focused on the treatment of lingual ectopy [ 2 , 3 , 46 , 47 , 48 , 49 , 50 , 51 , 57 , 58 , 59 , 60 , 61 , 62 ]; six studies were about patients with multinodular goiter [ 52 , 53 , 54 , 55 , 62 , 70 ]; six studies were carried out on patients with Graves’ disease [ 16 , 17 , 54 , 56 , 63 , 64 , 69 ]; a study on Hashimoto’s thyroiditis [ 54 , 69 ]; two studies on nodular goiter [ 54 , 56 , 69 ]; a study on unspecified postsurgical hypothyroidism [ 15 ] and a study on patients with thyrotoxicosis [ 65 ]. The heterograft sites are known in 23 out of 25 cases.…”

“…The heterograft sites are known in 23 out of 25 cases. The trunk was the most involved site [ 2 , 3 , 47 , 49 , 50 , 51 , 58 , 59 , 62 ], with prevalence of the rectus abdominalis, followed by the neck [ 48 , 50 , 54 , 57 , 60 , 61 , 63 , 64 , 69 ], especially the sternocleidomastoid. A less preferred site was the lower limb muscles [ 52 , 53 , 55 , 56 , 70 ], and the upper limb was chosen only once [ 16 ].…”

“…A less preferred site was the lower limb muscles [ 52 , 53 , 55 , 56 , 70 ], and the upper limb was chosen only once [ 16 ]. Immediate autotransplantation was performed in nearly all the studies (22 out of 25—88%) [ 2 , 3 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 69 ], while post-cryopreservation autotransplantation was performed in 3 studies (12%) [ 15 , 16 , 17 ]. The weight of transplanted thyroid was reported in 10 studies with an average of 7 g (range 0.5–20 g) [ 16 , 46 , 52 , 53 , 54 , 55 , 56 , 62 , 63 , 64 , 69 ].…”

“…The follow up of these patients had an average duration of 3.5 years (range 1 month-37 years). Studies in humans have been collected in Table 2 for a total of 25 publications ranging from 1938 to date [3,69]. Also, these reports were clustered according to their geographical distribution.…”