IMMEDIATE AUTOTRANSPLANTATION OF PARATHYROID GLAND (IAPG).

P661 Aims: iAPG is applied as treatment modality the patients with PHPT caused by solitary parathyroid adenoma. The aim of this technique is to prevent postoperative hypoparathyroidism by creating of parathyroid hormone reserve in the body. Methods: 23 patients with PHPT caused by solitary parathyroid adenoma were investigated. All patients have been undergone iAPG immediately after parathyroid adenoma removal. Effectiveness of the method was analyzed according to clinical and biochemical data (serum PTH, Ca and P values) during 7-720 days after surgery Results: Ejection of the graft and graft-dependent hypercalciemia were seen in non of the patient. 19 patient (82.6%) noticed favorable improvement in their subjective feelings in first days after operation. No tetanoid spasms were documented. In few patients mild hypocalcaemia was notices, which did not require replacement therapy and resolved independently in 3-8 days. Only 4 patients needed additional replacement therapy, as they had heavy hypocalcaemia syndrome after surgery. Effect of the transplantation was long and stable. Concentration of PTH (pg/ml) ranged 102+18.6 – 91.3+11.5 (P>0.05 to control – 102.7+6.7), plasma Ca (mMol/l) ranged 2.13+0.06 – 2.39+0.06, plasma P (mMol/l) ranged 1.19+0.06 – 1.01+0.08 during observation period. Conclusions: . iAPG is an effective adjuvant method of treatment in patients with PHPT caused by solitary parathyroid adenoma, providing good normocalcaemic control in these patients.

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