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Pediatric Postmortem Tissue Donation in the Confines of a Pandemic: A Model of Collaboration
Esteban U Arias-Stella1, Cindy Campbell1, David J Pisapia2
1Department of Neurological Surgery, Weill Cornell Medical College, New York, New York.
Background:
Obtaining postmortem tissue from pediatric oncology patients is critical to research and may help grieving families heal. Since 2019, the national Gift from a Child program has made significant progress in collecting postmortem tissue from pediatric patients with central nervous system tumors to advance research. This progress was at risk during the onset of the severe acute respiratory syndrome coronavirus 2 pandemic, when some autopsy programs came to a halt.
Methods:
We retrospectively reviewed autopsies of four patients treated at Memorial Sloan Kettering Cancer Center who underwent postmortem examination at Weill Cornell Medicine from June 2020 to March 2021. We collected patient demographics, Do not resuscitate status, time of death and procedure, restrictions due to the coronavirus disease 2019 (COVID-19) pandemic, and results of the tissue analysis.
Results:
Three of four specimens were processed within 12 hours of the time of death. Two families required interpreter services to obtain consent. In all cases, tumor aliquots were flash frozen for further study. Cell line generation was successful in one case. All families expressed gratitude both for the opportunity to participate and for the handling of the procedures.
Conclusions:
Despite the sensitive nature of these cases and the challenges presented by COVID-19 restrictions, clinicians should offer the option of a rapid autopsy to caregivers of pediatric patients based on the scientific need and the positive effect it has on grieving families. This article outlines the logistic efforts required for these donations to take place and provides a framework for providers to offer rapid autopsy as an option for families through this program.
Insights
Rapid autopsy programs for pediatric cancer patients are vital for research and family healing. Despite COVID-19 challenges, offering rapid autopsy donations is feasible and beneficial for grieving families.
Area of Science:
- Pediatric Oncology
- Translational Research
- Biobanking
Background:
- Postmortem tissue donation from pediatric oncology patients is crucial for advancing research.
- The national Gift from a Child program facilitates tissue collection from pediatric central nervous system tumors.
- The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic posed a threat to established autopsy programs.
Purpose of the Study:
- To assess the feasibility of rapid postmortem tissue collection in pediatric oncology patients during the COVID-19 pandemic.
- To evaluate the logistical aspects and outcomes of rapid autopsies.
- To highlight the importance of offering rapid autopsy as a research and support option for families.
Main Methods:
- Retrospective review of four pediatric oncology cases undergoing rapid autopsy at Weill Cornell Medicine (June 2020 - March 2021).
- Collection of data on patient demographics, consent, timing of death and procedure, COVID-19 restrictions, and tissue analysis.
- Focus on rapid processing of specimens for research.
Main Results:
- Three of four specimens were processed within 12 hours of death.
- Interpreter services were needed for two families during the consent process.
- Tumor aliquots were successfully flash-frozen for research; cell line generation was achieved in one case.
- Families reported gratitude for the donation opportunity and respectful handling of procedures.
Conclusions:
- Rapid autopsy programs are essential for pediatric cancer research and can aid family grieving processes.
- Despite pandemic-related challenges, offering rapid autopsy is logistically achievable and beneficial.
- This study provides a framework for implementing rapid autopsy donation programs for pediatric patients.
