Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands.
Neonatology. 2013;103(3):213-7. doi: 10.1159/000345921. Epub 2013 Jan 12.
The accrual of human tissues from autopsies for diagnostic and translational research has decreased significantly over the last decades.
The objective of this study was to evaluate our experience with lung biopsy through a minithoracotomy as an alternative for obtaining postmortem tissue when full autopsy is refused in congenital diaphragmatic hernia (CDH) patients.
Within 2 h of death we routinely asked parents for permission to perform an autopsy. Starting in 2001, parents who refused autopsy were asked permission for a postmortem lung biopsy. Pathology autopsy and biopsy reports were compared to clinical records.
Between 2001 and 2009, 46 patients died from CDH. Permission for autopsy was granted in 5 patients (11%). Of the remaining 41 patients, the parents of 15 (33%) agreed to postmortem lung biopsy. In all cases, additional findings were reported from the autopsy or biopsy, without changing the originally reported cause of death. In 1 case, we isolated fibroblasts from the lung biopsy using standardized cell culture techniques. Parents were able to take their child home with a minimal delay following biopsy.
Parents refusing a full autopsy frequently agree to postmortem organ biopsy. This approach should therefore be considered as a valuable alternative, when permission for full autopsy is declined, for obtaining human tissues for both diagnostic and research purposes and is potentially applicable to other anomalies.
在过去几十年中，用于诊断和转化研究的人体组织的积累量显著减少。
本研究的目的是评估我们通过小开胸术进行肺活检的经验，作为在拒绝进行全尸检的先天性膈疝（CDH）患者中获得死后组织的替代方法。
在死亡后 2 小时内，我们通常会征求家长的同意进行尸检。自 2001 年起，拒绝尸检的家长被要求同意进行死后肺活检。将病理尸检和活检报告与临床记录进行比较。
在 2001 年至 2009 年间，有 46 名 CDH 患者死亡。有 5 名患者（11%）的家长同意进行尸检。在其余 41 名患者中，有 15 名（33%）的家长同意进行死后肺活检。在所有情况下，尸检或活检均报告了其他发现，但并未改变最初报告的死因。在 1 例中，我们使用标准化的细胞培养技术从肺活检中分离出成纤维细胞。家长们能够在活检后尽快将孩子带回家。
拒绝全尸检的家长通常会同意进行死后器官活检。因此，当全尸检被拒绝时，这种方法应被视为一种有价值的替代方法，用于获取用于诊断和研究目的的人体组织，并且可能适用于其他异常情况。
