Optimisation and Status of Chelation Therapy

The calcium trisodium salt of diethylenetriaminepentaacetic acid (Ca-DTPA) remains the chelating agent of choice for treatment of incorporated actinides. The zinc trisodium salt (Zn-DTPA) represents a less toxic alternative, when Ca-DTPA is contra-indicated as well as for prolonged chelation therapy; in acute incorporation cases it would be less effective than Ca-DTPA. Specific iron binding chelators such as desferrioxamine (DFOA) and linear tetracatechoylamides, e.g., LICAM(C) proved more effective in animals injected with Pu, Th and Np (not with Am!) but only concerning the radioactivity in the bone; that in the kidneys was substantially increased. The combinations of DFOA or LICAM(C) with Ca-DTPA exerted the best overall effects. After incorporation of soluble uranium-compounds, an infusion of sodium bicarbonate seems at present the most reasonable for enhancing the uranium-excretion and prevention of kidney damage.