Technique and outcome of autotransplanting thyroid tissue after total thyroidectomy for simple multinodular goiters.
OBJECTIVE
Limited animal and human studies have shown function, albeit inadequate, of implanted thyroid tissue in muscles. This work aimed to ascertain results in a larger number of patients, finding practical method for implantation, studying the effect of changing weight of implant and effect of passage of time on its function.


METHODS
Forty patients had total thyroidectomy for simple multinodular goiters. A piece of the excised gland was finely minced, mixed with saline as emulsion, and injected in thigh muscles. Twelve patients had 5-g implants, while 28 patients had 10-g implants. Four parameters were studied at 2 months, 6 months, and 12 months: technetium isotope uptake by the implant; thyroid stimulating hormone (TSH); free T3 (FT3); and free T4 (FT4).


RESULTS
All autotransplanted thyroid tissue survived and functioned. After 12 months, mean values (± standard deviation) of isotope uptake, TSH, FT3, and FT4 of the 5-g implants were 0.44 ± 0.16%, 27.74 ± 30.4 UI/mL, 3.07 ± 1.10 pg/mL, and 1.01 ± 0.3 ng/dL, repectively. Those for the 10 g implants were 0.71 ± 0.20%, 22.78 ± 19.7 UI/mL, 3.92 ± 1.2 pg/mL, and 1.05 ± 0.3 ng/dL, repectively. Ten-gram implants showed significantly higher isotope uptake than 5-g. TSH, FT3, and FT4 significantly improved over the period of 1 year.


CONCLUSIONS
Injection of thyroid tissue suspension is a simple method for thyroid autotransplantation. TSH was elevated in the majority to maintain normal or near normal thyroid hormones. Ten-gram implants showed higher isotope uptake than 5-g, although this difference was not reflected by thyroid hormone profile. The implant seemed to function better with the passage of time from 2 months to 12 months.
Faculty of Medicine Cairo University, Cairo, Egypt.
Amr A
AA
Mohsen
Faculty of Medicine Cairo University, Cairo, Egypt.
Ahmed A
AA
Nada
Faculty of Medicine Cairo University, Cairo, Egypt. Electronic address: dr.mohamed_yehia@yahoo.com.
Mohamed Y
MY
Ibrahim
Faculty of Medicine Cairo University, Cairo, Egypt.
Ashraf H
AH
Ghaleb
Faculty of Medicine Cairo University, Cairo, Egypt.
Mahasen A
MA
Abou-Gabal
National Research Centre, Cairo, Egypt.
Ahmed A
AA
Mohsen
Faculty of Medicine Cairo University, Cairo, Egypt.
Arsany T
AT
Wassef
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D013961:Thyroid Gland / Q000637:transplantation*; D013965:Thyroidectomy; D014182:Transplantation, Autologous; D016896:Treatment Outcome
multinodular goiter; thyroid autotransplantation; thyroidectomy