Annals of surgery
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Parathyroid autografts were performed in 19 random bred mongrels and parathyroid allografts were exchanged between seven random bred mongrels. Three pairs of siblings from a beagle colony were immunosuppressed and parathyroid allografts exchanged between them. ⋯ In immunosuppressed animals, however, the allografts were successful in five of six dogs. The success of parathyroid transplantation was determined by the following observations: 1) The experimental animal, having grafted parathyroid tissue as the only source of hormone, maintained a normal or near normal serum calcium concentration. 2) Following removal of the parathyroid graft, there was an immediate fall in the serum calcium concentration associated with tetany and/or death. 3) Histological study of the grafted gland revealed normal architecture, and 4) Radioimmunoassay of extracted grafts revealed moderate to large quantities of parathyroid hormone.
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The IgG fraction of equine antithymocyte globulin administered by the intravenous and intramuscular route to two patients with severe thermal injury was associated with survival of the skin allografts to 19 and 42 days. In the second patient the IgG fraction was discontinued 28 days after skin grafting and rejection occurred 14 days later while the patient was receiving azathioprine and 1% topical hydrocortisone cream to the skin allografts. Although no comparison can be made between the immunosuppressive properties of antithymocyte globulin, azathioprine and topical steroids, skin allograft survival was prolonged temporarily until autograft skin from previous donor sites could be obtained. The use of skin allografts protected by immunosuppressive therapy in patients with severe thermal injury deserves further consideration.