Parathyroid auto-transplantation - a scoping review of techniques and outcomes

Parathyroid auto-transplantation (PAT) is a surgical technique in which parathyroid tissue is re-implanted back into the same patient to preserve parathyroid function following inadvertent devascularisation or excision during thyroid surgery, or after a total parathyroidectomy in a multi-gland disease of the parathyroid glands. Different techniques have been described, such as slicing or mincing the tissue, and implantation in different anatomical locations such as the sternocleidomastoid or brachioradialis muscles. There is also debate on the role of cryopreservation and its impact on the function of the auto-transplanted tissue. Reported success rates vary widely, from 10% to 100%, depending on technique, tissue processing, and outcome measurement. Despite its long-standing use, the literature on PAT is heterogeneous. The optimal method of auto-transplantation, assessment methods and definitions of a successful auto-transplantion procedure remain unclear. A scoping review is therefore warranted to map existing evidence, summarise the techniques used, and identify knowledge gaps.