title: Serial explantation after parathyroid autotransplant for recurrent hypercalcemia in chronic renal failure.
abstract: BACKGROUND
  Development of autonomous parathyroid gland function can occur in cases of long standing renal disease, leading to hyperparathyroidism and hypercalcemia. Debate exists over the optimum surgical treatment strategy and the choice lies with the individual surgeon. We illustrated the method of total parathyroidectomy and autotransplantation to the forearm and proposed it to be superior to both total and subtotal parathyroidectomy.
  
  
  METHODS
  This case illustrated the development of secondary and subsequently tertiary hyperparathyroidism in a 66-year-old man with a history of chronic renal failure. The patient was managed surgically by parathyroid autotransplantation and serial explantation.
  
  
  CONCLUSIONS
  Refractory hypercalcemia due to autonomous parathyroid tissue following parathyroidectomy can be managed with greater ease and efficacy by serial explantation of autotransplanted tissue versus a more difficult re-exploration of the neck.
authors.affiliation: School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.
authors.forename: William Robert
authors.initials: WR
authors.lastname: Foley
authors.affiliation: School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.
authors.forename: Dara
authors.initials: D
authors.lastname: Lundon
authors.affiliation: School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland ; Department of Nephrology, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Yvonnne
authors.initials: Y
authors.lastname: O'Meara
authors.affiliation: School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland ; General, Breast and Endocrine Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Tom
authors.initials: T
authors.lastname: Gorey
keywords: Hypercalcemia; Hyperparathyroidism; Parathyroid hormone
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