In addition to renal elimination and gastrointestinal metabolism (amyl
ase; splenic and hepatic dextranase) colloid plasma solutions like dex
tran and hydroxyethyl starch deposit in tissues, especially in the ret
iculoendothelial system (RES). This tissue storage is limited in time
(weeks to months),is influenced by the employed solution and other fac
tors (lysosomes) and has usually no clinical importance (no RES blocka
de). We report here a case study of a patient with sepsis (lung,liver
and kidney failure) who had an overload of the RES with colloids while
being treated with dextran (molecular weight 40000 and 70000 daltons)
and hydroxyethyl starch (mw 450000 daltons, molar substitution 0,7) f
or 5 weeks. Autopsy showed parenchymal and reticuloendothelial cells o
f liver,lung, kidney and spleen with a large amount of colloid mass in
clusions and altered organ morphology. This storage may have impaired
ventilation, transport of bile acids and renal function. A possible ro
le of tissue storage of colloids in organ failure is discussed.