TOTAL BODY IRRADIATION FOR ORGAN TRANSPLANTATION
The effects of high-dosage Co/sup 60/ irradiation in 11 patients undergoing kidney transplantation are described. Uniform whole-body exposure to doses of 400 to 450 rads (administered over 7 to 8 hr) appears to be well tolerated, provided that certain precautions are observed. With such doses, control. The risk of infection is much more serious; it would appear that this danger can be averted by observing strict aseptic precautions and that it is possible for a patient to live for a month or more in an atmosphere much more sterile than that of an operating theater. Under these conditions and by the use of antibiotics, not as a routine measure, but for specific therapy, it appears possible to reduce the risks of infection. The immediate effects of irradiation are relatively mild. During the actual exposure, when the dose reaches 150 to 200 rads the patient experiences a sensation of asthenia, with a tendency to nausea, and exhibits tachycardia, pallor, and anxiety. During the first few days after irradiatlon the symptoms were very slight. Loss of hair started on the 16th day and was complete on the 20th. None of the patients exhibited convulsions or neurological disturbances. The number of circulating reticulocytea fell immediately after irradiation, and from the 15th day was less than 5%. The count began to rise again at the same time as the white blood count increased. The number of lymphocytes fell rapidly 3 to 5 days after irradiation. The minimum was about 4% of the initial value, a figure similar to that observed in the rat after a dose of 400 r. In 4 of 5 patients, there was a slight rise in the lymphocyte count beginning on the 8th day and subsequently a fall. The number of lymphocytes then remained very low, until about the 22nd to 25th day. Granulocytes began to fall almost immediately after irradiation; the fall was precipitate at first, but became slower after the 5th day. The granulocyte court then remained constant or even showed a slight rise. From the 15th day the number began to fall again, reaching a minimum on the 18th day. During this phase of almost total agranulocytosis, the white cell count was below 500, sometimes below 200. The phase lasted about 7 days, with an increase again between the 22nd and 26th day, The platelet count reached a minimum between the 15th and 20th day. The hematological findings during the first 2 weeks after irradiatton in a pattent who received 600 rad were very similar to those of patients who received 400 rad. A 2nd irradintion 2 months later in several patients caused reactions of unexpected severity considering the dose (100 rad) and previous results in animals. Marked, persistent bone marrow aplasia occurred in both patients, and in one, led to fatal septicemia unresponsive to antibiotics. (H.H.D.)
- Research Organization:
- Originating Research Org. not identified
- NSA Number:
- NSA-17-005874
- OSTI ID:
- 4754053
- Journal Information:
- Proc. Roy. Soc. Med., Journal Name: Proc. Roy. Soc. Med. Vol. Vol: 54
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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