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Guinea pig lymphoid cells were reacted to form spontaneous rosettes (E-rosettes) with rabbit red blood cells before and after treatment with papain or a very low concentration (0.01%) of glutaraldehyde alone or both. The papain-glutaraldehyde-treated cells showed as high ability as papain-treated cells to rosette with lymphoid cells prepared from thymus, spleen, lymph node and peripheral blood of guinea pigs. Moreover, papain-glutaraldehyde-treated red cells were lyophilized and stored for 1 year without any change in their ability to form E-rosettes with these lymphoid cells. Binding between lymphocytes and treated or nontreated red cells was completely inhibited by specific anti-guinea pig thymocyte serum. Furthermore, a lymphocyte population enriched for B cells from lymph nodes or leukemic cells of strain 2 guinea pigs (B cells) did not show any substantial E-rosettes with nontreated or treated red cells. Scanning electron microscopy revealed no surface alteration in the treated cells when compared to those in nontreated red cells.

In the field of emergency medicine, it is not rare for patients to suffer brain death despite aggressive measures. With the establishment of the Organ Transplant Law in 1997, donations of organs such as heart , lungs, liver, pancreas, and small intestine from brain-dead patients became possible. However , as of today, organ donation remains rare, despite the large numbers of patients who await organ transplantation. Donation requires a family offer or an approach to a family about organ donation options by those caring for the patient. But, even if the patient expresses an interest in organ donation, the wills of the patient or the family cannot be honored unless the critical care physician approaches the family about organ donation options. During the period from January 2004 to November 2005 , 13 patients who suffered from severe brain damage survived for 24 hours or more after admission to the ICU , and were evaluated for clinical brain death. Then we approached the families of all 13 patients about organ donation options , the families of 12 patients expressed an interest in organ donation, and the families of 9 patients met with a donor coordinator. The families of all 9 patients agreed to donate organs and tissues, resulting in organ and tissue donations involving 17 kidneys , 1 pancreas (simultaneous donation of pancreas and kidney), 4 heart valves/aorta, 12 eyes, and 4 skin donations. At the terminal stages of critical care, there is a high degree of interest in organ donation among families of brain-dead patients , and blood relatives especially tended to agree to organ donation. Through the involvement of a donor coordinator , donations of organs and tissues were achieved for about 70% of the patients. It is concluded that critical care physicians and neurosurgeons approaching families about organ donation options can lead to increases in organ donations.

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