Building a Rapid Autopsy Program – A Step-by-Step Logistics Guide

Abstract

Background: Rapid Autopsy Programs offer an opportunity to collect tissue from patients immediately after death, providing critical biological material necessary to develop more effective therapies and improve patient outcomes. Here, we present a step-by-step guide to build a cancer-focused Rapid Autopsy Program, based on our own experiences building “The Legacy Project” at the City of Hope Comprehensive Cancer Center. Methods: The linear timeline of events is separated into four phases: 1) Building the Infrastructure, 2) Recruiting and Consenting, 3) Preparing for Death, and 4) Tissue Collection and Follow up. Important considerations and methods for adaptation are discussed throughout the protocol. Discussion: Using these methods, we successfully collected a total of 533 specimens from 9 subjects. The average time from death to last specimen acquisition was 6.1 hours (range: 4.03 – 7.66 hours; median: 5.71 hours). A diverse team with various areas of expertise is critical for successful program implementation. Our goal herein this protocol is to provide a comprehensive framework and foundation for other institutions to use as a model.

Kidney Disease and Viral Infection in COVID-19: Why Are Kidney Organoid and Biopsy Studies Not in Agreement?

“…In addition, reports of coronavirus-like particles identified in postmortem kidneys by other groups have been questioned due to the lack of rigorous criteria of virus identification, the resemblance of these particles to cytoplasmic organelles, and the presence of postmortem artifacts [ 8 , 9 ]. Ultrastructural evaluation of postmortem kidneys could be significantly improved in the future by the adoption of rapid autopsy protocols [ 38 ]. The mitigation of postmortem artifacts with this approach combined with the use of rigorous EM criteria of virus identification would facilitate the distinction between putative coronavirus particles and their cellular mimics in autopsy material.…”