Thyroid autotransplantation following total thyroidectomy in benign thyroid disorders: a new technique to avoid postoperative hypothyroidism

Abstract

Background: Although total thyroidectomy has become the operation of choice in treatment of BMNG, it leads to permanent hypothyroidism which lead the patient to take a lifelong exogenous hormone replacement therapy, which involves daily administration of levothyroxine at a dose that must be in close follow-up in terms of thyroid hormone levels. In addition, reaching euthyroid status using hormone replacement therapy can be affected in presence of other medical problems that interfere with absorption of the drug as mal-absorption syndrome. When all these are considered, there is a necessity of a novel method to avoid the occurrence of postoperative hypothyroidism.Methods: A case series prospective study carried out over 30 patients with benign thyroid disorders for whom total thyroidectomy is indicated to evaluate the capacity of auto-implanted thyroid tissue in achieving an euthyroid state without any need for life-long hormone replacement therapy. Postoperative Assessment consists of repeated thyroid function tests and thyroid scan with complementary SPECT/CT.Results: significant gradual increase in serum levels of T3 and T4 with corresponding decrease in TSH levels returning to normal levels 6-9 months postoperatively. Thyroid scan with complementary SPECT/CT was done for 15 patients to evaluate the functional capacity of the thyroid implant. Among the 15 patients, 13 patients have functioning thyroid implant (success percent: 6.6%). whereas 2 patients show non functioning thyroid implant (failure percent: 13.3%).Conclusions: Thyroid Auto-transplantation following total thyroidectomy in benign thyroid disorders is an effective method to prevent postoperative hypothyroidism.

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

“…Also, these reports were clustered according to their geographical distribution. In Figure 7 , it is possible to observe the geographical distribution of the studies, half of which were conducted in the US and Middle East [ 2 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 70 ]. The sample size for the most numerous study is over 240 patients.…”

“…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.…”

Rat thyroid graft transplantation after cryopreservation with scintigraphic standardization for an experimental study

“…Although the autoimmune aspect of Graves’ disease plays a key role, it is found in the respective literature that patients with thyroid autotransplantation did not evolve with relapsing thyrotoxicosis. 25 , 29 , 30 , 31 , 32 , 33 …”

Cryopreserved Rat Thyroid Autotransplantation in the Treatment of Postoperative Hypothyroidism

“…techniques (immediate transplantation versus cryopreservation), in addition to several different locations of the implanted tissue, have been found. Finally, different types of grafts (culture or emulsion versus thyroid fragments) and postoperative follow-up times have been used (1,8,(11)(12)(13)(14)(15)(16)(17).…”

“…Choosing the ideal location for thyroid transplantation has to take into account several factors, such as a less invasive procedure, easy access and a low-risk incision. Hence, our choice was based on experimental and clinical studies whose heterotopic grafts were successfully implanted in skeletal muscle tissue with greater clinical applicability (12,15,17).…”