Selection Criteria Optimal for Recovery of Inner Ear Tissues From Deceased Organ Donors

Abstract

Objective:To identify optimal conditions for recovering viable inner ear tissues from deceased organ donors.Setting:Tertiary recovery hospitals and Donor Network West Organ Recovery Center.Interventions:Recovering bilateral inner ear tissues and immunohistological analysis.Main Outcome Measures:Immunohistochemical analysis of utricles from human organ donors after brain death (DBD) or donors after cardiac death (DCD).Results:Vestibular tissues from 21 organ donors (39 ears) were recovered. Of these, 18 donors (33 utricles) were examined by immunofluorescence. The sensory epithelium was present in seven utricles (two from DBD and five from DCD). Relative to DBD utricles, DCD organs more commonly displayed dense populations of hair cells and supporting cells. Relative to DBD, DCD had significantly shorter postmortem interval time to tissue recovery (<48 h). Compared to donors with no sensory epithelium, donors with intact and viable sensory epithelium (both DCD and DBD) had significantly shorter lag time to resuscitation prior to hospital admission (6.4 ± 9.2 vs 35.6 ± 23.7 min, respectively) as well as a shorter time between pronouncements of death to organ recovery (22.6 ± 30.4 vs 64.8 ± 22.8 h, respectively).Conclusions:Organ donors are a novel resource for bilateral inner ear organs. Selecting tissue donors within defined parameters can optimize the quality of recovered inner ear tissues, thereby facilitating future research investigating sensory and nonsensory cells.

Single-cell transcriptomic atlas reveals increased regeneration in diseased human inner ears

“…To characterize the human utricle, we harvested tissues from two cohorts: organ donors and vestibular schwannoma patients (Table S1). We previously devised a surgical approach to procure unilateral or bilateral utricles from organ donors (OD) (Aaron et al, 2022; Vaisbuch et al, 2022), who lacked any history of auditory or vestibular dysfunction (Table S1). In parallel, utricles were procured from patients with unilateral vestibular schwannomas and ipsilateral auditory and/or vestibular deficits, undergoing a translabyrinthine approach for tumor resection.…”

“…Organ donors were referred by Donor Network West (San Ramon, CA). Bilateral utricles were harvested from organ donors as previously described (Aaron et al, 2022; Vaisbuch et al, 2022). Briefly, a post-auricular incision was made followed by a transcanal approach to expose the middle ear.…”

Surgical Approach for Rapid and Minimally Traumatic Recovery of Human Inner Ear Tissues From Deceased Organ Donors

“…This allows the inner ear tissue to be evaluated in its freshest state. The characteristics and quality of tissue recovery during this project is separately reported in a paper by our group (8).…”

“…The underlying cause of death of the organ or tissue donors was either brain death or cardiac death. The team was provided with the baseline demographics of the donor and their hospitalization course (8). The extraction of the tissue occurred during after-hours.…”

“…Immediately after the tissue was recovered it was placed into a physiological buffer solution for an initial microscopic evaluation of tissue damage. This was incorporated into the process in order to provide immediate feedback to the surgeon on any improvements associated with procurement and tissue handling technique in advance of the second ear (8). This was especially critical early on in the project as there was a learning curve for the initial cases.…”