Successful Deceased Donor Parathyroid Allotransplantation: A Novel Approach in a Patient with Severe Refractory Hypoparathyroidism after Thyroidectomy for Thyroid Cancer

Background Hypoparathyroidism following thyroid surgery presents significant challenges, often leading to debilitating symptoms and reduced quality of life despite conventional treatment. We describe a patient who had a staged total thyroidectomy for low-risk thyroid cancer and developed severe refractory iatrogenic hypoparathyroidism in whom we performed the first successful fresh normal-tissue deceased donor parathyroid transplant in an immune-naïve recipient. Methods A rigorous protocol for donor selection and transplantation was developed. Donor criteria aimed at minimizing infectious and immunological risks. Surgical techniques involved retrieval and transplantation of healthy parathyroid glands from a deceased donor into the recipient's muscle tissue, followed by immunosuppression. Results Following transplantation, the patient exhibited rapid resolution of symptoms, normalization of calcium levels, and cessation of calcium supplementation. Follow-up-has revealed sustained graft function without the need for additional therapy. Conclusion Deceased donor parathyroid allotransplantation emerges as a promising therapeutic option for severe refractory hypoparathyroidism, underscoring the potential for physiologic cure and improved quality of life in patients with this debilitating complication of thyroid cancer surgery. Further research is warranted to validate the efficacy and safety of this innovative approach.