#0084 Indium kinetics in an indium exposed worker before and after bilateral lung transplantation
Having a good pair of lungs: Treating ITO induced lung damage by transplanting both lungs
Workplace-related health hazard is one of the most prominent concerns in public health arena. A common occupational health concern is respiratory health and safety of workers who are exposed to chemical or airborne pollutants that affect the respiratory system. While the rapid inclusion of new chemical compounds in the industrial space brings technological advancement, unprotected and unregulated usages of many of these compounds can be dangerous to the health of the workers. To develop efficient treatment strategies for workers exposed to these compounds, it is important to comprehensively assess the effect of these compounds on the body.
Indium tin oxide (ITO) is a technologically important semiconductor that is used in flat panel displays. Public-health watchers have identified ITO as a potent risk factor as some recent reports highlighted the incidents of severe lung damage in ITO-exposed workers and experimental animals. However, effective therapy for ITO exposure is yet to be developed. Recently, for the first time in clinical history, we successfully treated a worker with severe lung disease that was caused by prolonged ITO dust exposure.
In this patient, we observed that the effect of long-term inhalation of ITO particles manifested itself through several structural and physiological changes in the lungs. The injured lungs bore the evidence of progressively destroyed tissues that lead the patient to develop severe emphysema or shortness of breath and pulmonary hypertension. We found the physical presence of indium and tin in his lungs, lymph nodes, and serum. To treat this patient, we transplanted both of his lungs, one at a time, with a donor’s lungs and after transplantation, continued the clinical observation for 122 weeks. We found that during this follow-up period, while the level of indium remained high in serum the level of KL-6, a marker of lung inflammation, remained normal indicating the restored normalcy in the lungs. More importantly, the transplanted lungs were not affected by the indium that remained in the body.
Our treatment strategy of transplanting both of his lungs cured the lungs of ITO-exposure related damage and eventually helped the patient get back to normal life. We believe, in severe indium lung disease cases, lung transplantation can be an effective treatment option.
Link to the original journal article:
https://onlinelibrary.wiley.com/doi/10.1002/1348-9585.12165
Title of the paper:
Indium kinetics in an indium exposed worker before and after bilateral lung transplantation
Authors:
Makiko Nakano, Miyuki Hirata, Makoto Hamasaki, Akiyo Tanaka, Asahi Nagata, Hiroyuki Kumazoe, Kentaro Wakamatsu, Takeshi Shiraishi, Kazuyuki Omae
