Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists | 2019
CRYOPRESERVATION OF PARATHYROID TISSUE: A WHITE PAPER ON ESTABLISHING A LOCAL SERVICE.
Abstract
OBJECTIVES\nPreservation of parathyroid function is one of the primary tenets of endocrine surgery. For patients with thyroid disease, an inadvertently compromised parathyroid gland is routinely auto transplanted into the neck at the time of surgery. By contrast for patients with parathyroid disease secondary to hyperplasia, the timing of auto transplantation needs to be further considered in order to balance the risks between persistent disease and permanent hypocalcaemia. Cryopreservation preserves cellular function and permits the storage of parathyroid tissue for potential re-implantation at a later date, in patients who develop hypoparathyroidism.\n\n\nMETHODS\nIn this paper we review the process of cryopreservation, with particular emphasis on the regulatory issues involved in establishing a local service, tissue processing, billing and reimbursements, outcome (functionality) and complications.\n\n\nRESULTS\nA detailed description of the technique as performed at our institution is described and illustrated.\n\n\nCONCLUSIONS\nCryopreservation affords surgical insurance against the disastrous sequelae of permanent hypoparathyroidism. Our techniques are easy to adopt with only a modest initial investment of time and money, particularly for institutions that already cryopreserve other tissue types.