Abstract：
BACKGROUND:Rapid intraoperative parathyroid hormone (RI-PTH) assay is used to guide adequacy of resection during operation for hyperparathyroidism. We compared the RI-PTH assay (15 minutes) with a standard PTH assay, determined whether the PTH half-life varied between patients, and constructed a kinetic analysis of the RI-PTH data. METHODS:Forty-five patients with hyperparathyroidism had blood sampled at baseline and at times after parathyroid resection. Intact PTH was determined using RI-PTH and a standard assay. Values were fitted to an exponential decay curve using the baseline and the follow-up time points. PTH half-life and the new postexcision baseline value were calculated from the decay curve. RESULTS:The RI-PTH assay and the standard PTH assay correlated well. Average PTH half-life was 1.68 +/- 0.94 minutes (0.42 to 3.81 minutes). A kinetic analysis yielded a formula for the generation of a PTH decay curve. Using a 50% reduction in RI-PTH at 5 minutes as the criterion for adequate resection, 2 patients were incorrectly classified as not being cured. These patients were correctly classified using the kinetic analysis. CONCLUSIONS:PTH half-life can vary substantially. A kinetic analysis may be more accurate in assessing adequacy of resection. This method allows the surgeon to interpret RI-PTH data independent of the timing of samples.
journal_name
Surgeryjournal_title
Surgeryauthors
Libutti SK,Alexander HR,Bartlett DL,Sampson ML,Ruddel ME,Skarulis M,Marx SJ,Spiegel AM,Simmonds W,Remaley ATdoi
10.1067/msy.2099.101835subject
Has Abstractpub_date
1999-12-01 00:00:00pages
1145-50; discussion 1150-1issue
6eissn
0039-6060issn
1532-7361pii
S0039-6060(99)70074-7journal_volume
126pub_type
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