{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T07:14:48Z","timestamp":1786691688832,"version":"build-2736575974"},"reference-count":58,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:sec id=\"ab-soi240008-4\"><jats:title>Importance<\/jats:title><jats:p>Delayed autotransplantation of cryopreserved parathyroid tissue (DACP) is the only surgical treatment for permanent postoperative hypoparathyroidism. Studies suggest that only a small minority of cryopreserved samples are ultimately autotransplanted with highly variable outcomes. For these reasons, many have questioned the economic utility of the process, although, to the authors\u2019 knowledge, this has never been formally studied.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi240008-5\"><jats:title>Objective<\/jats:title><jats:p>To report the clinical outcomes of parathyroid cryopreservation and DACP at a large academic institution and to determine the cost-effectiveness of this treatment.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi240008-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>An institutional review board\u2013approved, retrospective review of patients at a single institution who underwent DACP over a 17-year period was conducted with a median follow-up of 48.2 months. A forward-looking cost-utility analysis was then performed to determine the economic utility of cryopreservation\/DACP vs usual care (monitoring and supplementation). Patients who had parathyroid tissue in cryopreserved storage between August 2005 to September 2022 at a single-center, academic, quaternary care center were identified.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi240008-7\"><jats:title>Exposure<\/jats:title><jats:p>Parathyroid cryopreservation and DACP.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi240008-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Graft functionality, clinical outcomes, and cost utility using a willingness-to-pay threshold of $100\u202f000 per quality-adjusted life-year (QALY).<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi240008-9\"><jats:title>Results<\/jats:title><jats:p>A total of 591 patients underwent cryopreservation. Of these, 10 patients (1.7%; mean [SD] age, 45.6 [17.9] years; 6 male [60%]) underwent DACP. A minority of autografts (2 [20%]) were subsequently fully functional, one-half (5 [50%]) were partially functional, and 3 (30%) were not functional. The cost-utility model estimated that at a large academic center over 10 years, the additional cost of 591 patients undergoing cryopreservation and 10 patients undergoing autotransplantation would be $618\u202f791.64 (2022 dollars) and would add 8.75 QALYs, resulting in a cost per marginal QALY of $70\u202f719.04, which is less than the common willingness-to-pay threshold of $100\u202f000\/QALY.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi240008-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The reimplantation rate of cryopreserved tissue was low (&amp;amp;lt;2%), but when implanted, autografts were at least partially functional 70% of the time. In the first-ever, to the authors\u2019 knowledge, formal cost analysis for this treatment, results of the current model suggest that cryopreservation and autotransplantation were cost-effective compared with the usual care for hypoparathyroidism at a large, academic institution. It is recommended that each surgical center consider whether the economic and logistical commitments necessary for cryopreservation are worthwhile for their individual needs.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamasurg.2024.0175","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T15:00:46Z","timestamp":1710946846000},"page":"634","source":"Crossref","is-referenced-by-count":10,"title":["Cost-Effectiveness of Parathyroid Cryopreservation and Autotransplantation"],"prefix":"10.1001","volume":"159","author":[{"given":"C. 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