Radiation and Borrowed Tissues

Abstract

The first four papers in this issue of Radiology, originally presented as a Symposium on Bone Marrow Transplants and General Immunological Problems, at the Forty-fifth Annual Meeting of the Radiological Society of North America, in November 1959, discuss exciting new lines of thought in radiology. They deal with the transplantation of bone marrow and other tissues into individuals who have received lethal or near-lethal doses of radiation. The potential for the saving of human lives from radiation accidents is enough to stimulate us. Beyond this, however, are the implications of therapeutic application associated with radiation given purposefully to near-lethal dosages. This might be expressed as the concept of intentional approach to the brink of radiation disaster followed by heroic rescue through another's tissues. Spectacular medical advances may be achieved by this means. I t is possible that a cure for leukemia may be offered by such high-dosage whole-body irradiation, with cell repopulation from a donor's healthy marrow. The treatment of testicular tumors and other malignant neoplasms might be notably improved. A means may be offered for safe transplantation of whole organs from one human being to another. These hopes are not likely to be achieved easily. The combined efforts of the radiobiologist, geneticist, and immunologist have already paved the way. The reports given here are encouraging, but they also bear witness to the many problems that are yet to be surmounted. We do not know how high the levels of radiation dosage can be pushed, nor what is required for the suppression of such human disease as leukemia. Much remains to be explored in the immunological phenomena of acceptance or rejection between host and transplant. The late unfavorable sequelae are still an unsolved problem. But these difficulties should not cloud the remarkable achievements already attained. To have successfully effected the removal of a kidney into a new host and to have observed it functioning there—a living chimaera—gives high promise for a new era in medicine. What should be the radiologist's role in these new developments? Clearly, this is not a suitable activity for the casual amateur, but rather for highly integrated units of specialists. We can all be interested in the challenge of this research endeavor and inform ourselves concerning its progress. In the near future, however, few of us are likely to be directly involved in this endeavor, and this is as it should be. A comprehensive mastery of special radiobiological background by the radiologist is required. This must be closely allied to a cooperative effort by radiobiologists, radiological physicists, and other pertinent medical and biological specialists. All of these must be fully informed of the current state of similar work elsewhere.