{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T20:31:19Z","timestamp":1774038679115,"version":"3.50.1"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Background.<\/jats:title>\n            <jats:p>Parathyroid allotransplantation is a burgeoning treatment for severe hypoparathyroidism. Deceased donor parathyroid gland (PTG) procurement can be technically challenging due to lack of normal intraoperative landmarks and exposure constraints in the neck of organ donors. In this study, we assessed standard 4-gland exposure in situ and en bloc surgical techniques for PTG procurement and ex vivo near-infrared autofluorescence (NIRAF) imaging for identification of PTGs during organ recovery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods.<\/jats:title>\n            <jats:p>Research tissue consent was obtained from organ donors or donor families for PTG procurement. All donors were normocalcemic, brain-dead, solid organ donors between 18 and 65 y of age. PTGs were procured initially using a standard 4-gland exposure technique in situ and subsequently using a novel en bloc resection technique after systemic organ preservation flushing. Parathyroid tissue was stored at 4\u2009\u00b0C in the University of Wisconsin solution up to 48 h post-procurement. Fluoptics Fluobeam NIRAF camera and Image J software were utilized for quantification of NIRAF signal.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results.<\/jats:title>\n            <jats:p>Thirty-one brain-dead deceased donor PTG procurements were performed by abdominal transplant surgeons. In the initial 8 deceased donors, a mean of 1.75 glands (\u00b11.48 glands SD) per donor were recovered using the 4-gland in situ technique. Implementation of combined en bloc resection with ex vivo NIRAF imaging in 23 consecutive donors yielded a mean of 3.60 glands (\u00b10.4 SD) recovered per donor (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001). Quantification of NIRAF integrated density signal demonstrated &gt;1-fold log difference in PTG (2.13 \u00d7 10<jats:sup>5<\/jats:sup> pixels) versus surrounding anterior neck structures (1.9 \u00d7 10<jats:sup>4<\/jats:sup> pixels; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001). PTGs maintain distinct NIRAF signal from the time of recovery (1.88 \u00d7 10<jats:sup>5<\/jats:sup> pixels) up to 48 h post-procurement (1.55 \u00d7 10<jats:sup>5<\/jats:sup> pixels) in organ preservation cold storage (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.34).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions.<\/jats:title>\n            <jats:p>The use of an en bloc surgical technique with ex vivo NIRAF imaging significantly enhances the identification and recovery of PTG from deceased donors.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/txd.0000000000001306","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T21:00:09Z","timestamp":1646946009000},"page":"e1306","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Procurement of Deceased Donor Parathyroid Glands With the Aid of Near-infrared Autofluorescence Imaging"],"prefix":"10.1097","volume":"8","author":[{"given":"Casey J.","family":"Ward","sequence":"first","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne M.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shareef M.","family":"Syed","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael P.H.","family":"Meier","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadasuke","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Oita University, Yufu, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven A.","family":"Wisel","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter G.","family":"Stock","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quan-Yang","family":"Duh","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"R1-20240805","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1017\/S0022215106003501","article-title":"Parathyroid risk in total thyroidectomy for bilateral, benign, multinodular goitre: report of 351 surgical cases.","volume":"121","author":"Page","year":"2007","journal-title":"J Laryngol Otol"},{"key":"R2-20240805","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1210\/jc.2015-3908","article-title":"Epidemiology and diagnosis of hypoparathyroidism.","volume":"101","author":"Clarke","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"R3-20240805","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1001\/archsurg.2007.55","article-title":"Hypoparathyroidism after total thyroidectomy: a prospective study.","volume":"143","author":"Asari","year":"2008","journal-title":"Arch Surg"},{"key":"R4-20240805","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.1002\/jbmr.2004","article-title":"Prevalence and incidence of hypoparathyroidism in the United States using a large claims database.","volume":"28","author":"Powers","year":"2013","journal-title":"J Bone Miner Res"},{"key":"R5-20240805","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.surg.2019.06.056","article-title":"Morbidity in patients with permanent hypoparathyroidism after total thyroidectomy.","volume":"167","author":"Bergenfelz","year":"2020","journal-title":"Surgery"},{"key":"R6-20240805","doi-asserted-by":"crossref","first-page":"671","DOI":"10.4158\/EP13328.OR","article-title":"Understanding the burden of illness associated with hypoparathyroidism reported among patients in the PARADOX study.","volume":"20","author":"Hadker","year":"2014","journal-title":"Endocr Pract"},{"key":"R7-20240805","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/S2213-8587(13)70106-2","article-title":"Efficacy and safety of recombinant human parathyroid hormone (1-84) in hypoparathyroidism (REPLACE): a double-blind, placebo-controlled, randomised, phase 3 study.","volume":"1","author":"Mannstadt","year":"2013","journal-title":"Lancet Diabetes Endocrinol"},{"key":"R8-20240805","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.surge.2020.06.008","article-title":"Parathyroid allotransplantation to treat post-thyroidectomy hypoparathyroidism: a review of case studies.","volume":"19","author":"Parameswaran","year":"2021","journal-title":"Surgeon"},{"key":"R9-20240805","article-title":"Parathyroid allotransplantation for the treatment of permanent hypoparathyroidism: a systematic review","author":"Kim","journal-title":"Am J Surg"},{"key":"R10-20240805","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/00007890-198336060-00001","article-title":"Allotransplantation of human parathyroid tissue without immunosuppression.","volume":"36","author":"Sollinger","year":"1983","journal-title":"Transplantation"},{"key":"R11-20240805","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.transproceed.2008.12.026","article-title":"Simultaneous kidney-parathyroid allotransplantation from a single donor after 20 years of tetany: a case report.","volume":"41","author":"Chapelle","year":"2009","journal-title":"Transplant Proc"},{"key":"R12-20240805","doi-asserted-by":"crossref","first-page":"e180","DOI":"10.1177\/000313482008600405","article-title":"Fresh tissue parathyroid allotransplantation from a cadaveric donor without immunosuppression: a 3-year follow-up.","volume":"86","author":"Aysan","year":"2020","journal-title":"Am Surg"},{"key":"R13-20240805","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1001\/jamasurg.2019.4613","article-title":"Association of autofluorescence-based detection of the parathyroid glands during total thyroidectomy with postoperative hypocalcemia risk: results of the PARAFLUO multicenter randomized clinical trial.","volume":"155","author":"Benmiloud","year":"2020","journal-title":"JAMA Surg"},{"key":"R14-20240805","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.jamcollsurg.2018.12.044","article-title":"Randomized controlled trial comparing white light with near-infrared autofluorescence for parathyroid gland identification during total thyroidectomy.","volume":"228","author":"Dip","year":"2019","journal-title":"J Am Coll Surg"},{"key":"R15-20240805","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1245\/s10434-018-6364-2","article-title":"Detection of parathyroid autofluorescence using near-infrared imaging: a multicenter analysis of concordance between different surgeons.","volume":"25","author":"Kahramangil","year":"2018","journal-title":"Ann Surg Oncol"},{"key":"R16-20240805","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.surg.2015.06.047","article-title":"Establishing the clinical utility of autofluorescence spectroscopy for parathyroid detection.","volume":"159","author":"McWade","year":"2016","journal-title":"Surgery"},{"key":"R17-20240805","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.surg.2017.06.022","article-title":"Impact of autofluorescence-based identification of parathyroids during total thyroidectomy on postoperative hypocalcemia: a before and after controlled study.","volume":"163","author":"Benmiloud","year":"2018","journal-title":"Surgery"},{"key":"R18-20240805","doi-asserted-by":"crossref","first-page":"067012","DOI":"10.1117\/1.3583571","article-title":"Near-infrared autofluorescence for the detection of parathyroid glands.","volume":"16","author":"Paras","year":"2011","journal-title":"J Biomed Opt"},{"key":"R19-20240805","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.surg.2020.09.014","article-title":"Current state of intraoperative use of near infrared fluorescence for parathyroid identification and preservation.","volume":"169","author":"Sol\u00f3rzano","year":"2021","journal-title":"Surgery"},{"key":"R20-20240805","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1007\/s002680010218","article-title":"Intraoperative parathyroid aspiration and parathyroid hormone assay as an alternative to frozen section for tissue identification.","volume":"24","author":"Perrier","year":"2000","journal-title":"World J Surg"},{"key":"R21-20240805","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1097\/TP.0000000000001042","article-title":"Simultaneous living donor kidney and parathyroid allotransplantation: first case report and review of 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