The Transplantation of Parathyroid Tissue in Man: Development, Indications, Technique, and Results

ONE HUNDRED years ago, the Swedish medical student Ivan Sandström (1) discovered the parathyroid glands in dogs and described their existence in man, horses, oxen, rabbits, and cats. He never realized the significance of his discovery or the important function of this organ in the control of calcium metabolism. For a long time the function of this organ remained unidentified, and tetany after thyroid surgery was considered the result of the absence of the thyroid. Not until it was discovered that the parathyroid glands were closely linked to tetany did they begin to receive attention. Gley (2) observed that 14 of 16 rabbits died of tetany if, together with the thyroid gland, two other glands lying underneath it were removed. Subsequent attempts to repeat these experiments failed because nothing was known about the internal and external arrangements of these glands. Not until Kohn (3) described these internal glands as existing in a great variety of animals did the basis exist for the experiments of two Italian researchers, Vassale and Generali (4). They found that removal of the parathyroid glands with retention of the thyroid gland caused tetany in animals; removal of the thyroid gland with retention of the parathyroid glands caused myxedema and cachexia. These results were confirmed in independent experiments by Waldbaum (5), Pineles (6), Hagenbach (7), Pfeiffer and Mayer (8), and Iselin (9).