Abstract
On 25 June 1990 in Shanghai, two men (Shi, a 56-year-old male, and Wan, a 53-year-old male) were accidentally exposed to homogeneous high dose and high dose rate 60Co irradiation (total activity 0.85 PBq, at the time of delivery from the manufacturing factory in June 1960) up to 12 Gy and 11 Gy, respectively. Both suffered from an extremely severe haematopoietic form of acute radiation sickness. Through energetic salvage and human leukocyte antigen (HLA) haploidentical bone marrow transplantation, their survival times were prolonged to 25 days and 90 days, respectively. In the case of Wan, the implanted bone marrow resided and engrafted completely, and haematopoiesis was restored. However, the patient died of interstitial pneumonia 90 days after exposure to radiation. The clinical course of multi-organ failure and the valuable experience obtained from the management of these patients is of great significance in directing the prevention of multi-organ failure and the treatment of such patients in the future. Pathological findings from these two autopsy cases are helpful in elucidating the underlying pathogenesis of clinical multi-organ failure, the cause of death and especially, the pathogenesis and morphogenesis of lung fibrosis.
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