This Article Figures Only Full Text Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Meineke, V Articles by Fliedner, T M Search for Related Content PubMed PubMed Citation Articles by Meineke, V Articles by Fliedner, T M

Radiation-induced multi-organ involvement and failure: challenges for radiation accident medical management and future research

¹ Bundeswehr Institute of Radiobiology, 80937 Munich and ² Radiation Medicine Research Group, Faculty of Medicine, University of Ulm, Germany

Correspondence: Viktor Meineke, Institut für Radiobiologie der Bundeswehr, Neuherbergstrasse 11, 80937 München, Germany. E-mail: ViktorMeineke@bundeswehr.org

A common feature of radiation accidents is the medical consequences of dose-dependent radiation-induced multi-organ involvement (RIMOI) and radiation-induced multi-organ failure (RIMOF). Both RIMOI and RIMOF contribute to the clinical outcome and prognosis of radiation accident victims. A most remarkable fact in this context is that the specific pathophysiological mechanisms involved in RIMOI and RIMOF as a function of time and in relation to the extent of radiation injury as well as the therapeutic ratios for specific treatment options based on our understanding of the roles of failure or the regenerative potential of different organs to a large extent remain unknown. A re-visit of the case reports of patients suffering from RIMOF as a consequence of RIMOI underlines the specific roles of individual organs, for example the haematopoietic system as one of the most sensitive and critical organs for early radiation-induced health impairments. The development of such radiation-induced impairments gains more and more attention, in particular after successfully coping with the consequences of haematopoietic failure using modern techniques such as stem cell transplantation and cytokine treatment to restore haematopoietic functions. Other equally important organs in the course of the development of RIMOF, such as the skin, neurovascular system, respiratory system or gastrointestinal system, need to be considered as contributors to the course and clinical outcome. The search for common denominators that are crucial in the pathogenesis of such a multi-organ functional impairment is of utmost importance. Thus, the pathophysiology of RIMOF is an extremely important and emerging challenge, and it is important to utilise the evolving new knowledge to develop new tools for the medical management of radiation accident victims. The "Advanced Research Workshop on Radiation-Induced Multi-organ Involvement and Failure" held at the Science Conference Center Schloss Reisensburg in November 2003 significantly contributed to the understanding of the role of RIMOI and RIMOF in the management of radiation accident victims. Moreover, it opened perspectives and challenges for future clinical and molecular–biological research in this specific area.