Decorporation

Decorporation is a medical concept describing interventions aimed at removing radioactive or toxic substances that have been absorbed and distributed within the body. The goal is to reduce internal radiation dose and tissue injury by increasing the elimination of the contaminant. It is distinct from external decontamination of skin or clothing, which addresses surface contamination rather than systemic burden.

The most established decorporation methods rely on chelating agents or adsorbents that bind the contaminant and promote its excretion. For many actinides such as plutonium, americium, and curium, calcium-DTPA or zinc-DTPA are used to mobilize the radionuclide from tissues into the bloodstream for renal elimination. For cesium-137 and thallium, Prussian blue binds the ions in the gut, reducing absorption and enhancing fecal excretion.

Effectiveness depends on the radionuclide, dose, time since exposure, and tissue distribution. Decorporation is generally more beneficial when started promptly after intake, and it may not be effective for all isotopes or after widespread tissue binding. Potential adverse effects include nephrotoxicity with certain chelators and constipation or electrolyte changes with Prussian blue; treatment is administered under medical supervision and tailored to the isotope and patient.

Decorporation is used in radiological emergencies, occupational exposure, and certain cases of toxic metal poisoning. It is supported by international guidelines and requires careful assessment of risks, benefits, and timing. It complements decontamination, supportive care, and exposure mitigation rather than replacing these measures.