Trial of thyroid auto-transplantation after total thyroidectomy in benign thyroid diseases

Background: Thyroid auto transplantation was introduced after the success of parathyroid auto transplantation. Heterotopic
thyroid autotransplantation is a technique that preserves viable thyroid tissue in the body after total thyroidectomy, which
may revascularize and restore thyroid function.
Thyroid autotransplantation can help avoid lifetime thyroid hormone replacement therapy, which may have some
drawbacks such as disruption of lipid metabolism, coronary heart disease, non-compliance, and malabsorptionThyroid
autotransplantation can also preserve the inner auto-regulatory mechanism of thyroid hormone production, which can
adjust to the body’s needsThyroid autotransplantation can prevent reoperation at the site of previous neck surgery in cases
of recurrent goiters or hyperthyroidism, which can be associated with a high rate of complications. heterotopic thyroid
autotransplantation is still not a popular technique and there is limited data on its long-term outcomes and safety. Some
studies have reported satisfactory results in terms of survival and function of the thyroid implant, but the number of
patients and the follow-up periods were very low. There are also some challenges and controversies regarding the optimal
site, size, and number of the grafts, as well as the indications and contraindications of this procedure.
Aim & Objectives: To ascertain the efficacy of auto transplantation of thyroid graft after total thyroidectomy (TT) for
benign simple multi nodular goiter.
Study period: 24 Months from January 2022 to January 2023 (including 12 months postoperative follow up).
Patients and Methods: The study will enroll 30 patients with benign nodular goiter who will undergo total thyroidectomy
and heterotopic thyroid autotransplantation in the vastus lateralis muscle of the thigh. The follow-up protocol includes
measurement of serum levels of T3, T4, and TSH and thyroid scintigraphy using 99mTc-MIBI.
Results: The study population consisted of 73.3% females and 26.7% males with a mean age of 33 years. . The mean
duration of surgery was 133.47 min. One month after surgery, duplex ultrasonography showed positive graft uptake
in 73.3% of patients and negative uptake in 26.7% of patients. Radioactive iodine scintigraphy showed positive graft
function in 80% of patients after 12 months. Euthyroidism was achieved in 80% of patients 12 months after surgery,
while 6.6% of patients had poor outcomes and required full-dose hormone replacement therapy and 13.3% of patients
had partial outcomes and required low-dose levothyroxine supplementation to attain euthyroidism. (levothyroxine 50).
Conclusion: Heterotopic thyroid autotransplantation is a feasible, effective, and efficient procedure after total
thyroidectomy for benign thyroid disorders.