Memorial Sloan Kettering Cancer Center,New York,New York.
New York-Presbyterian/Weill Cornell Medical Center,New York,New York.
Palliat Support Care. 2018 Apr;16(2):238-242. doi: 10.1017/S1478951517000864. Epub 2017 Sep 25.
ABSTRACTObjective:Our aim was to outline a procedure for obtaining a rapid autopsy in order to collect high-quality postmortem tissue for genomic analysis.
This report details a bi-institutional collaborative effort to coordinate a rapid autopsy for a pediatric patient who had died at home. We discuss the scientific rationale for offering a rapid autopsy to caregivers of pediatric patients as well as parental perspectives on broaching the subject of autopsy. We then review the logistics and coordination involved with planning a rapid autopsy and the sequence of events needed to maximize tissue quality.
We report the successful coordination of a rapid autopsy for a patient who died in a hospice setting at her out-of-state home. The time interval from death to the start of the rapid autopsy procedure was 4.5 hours, despite the logistical considerations demanded by the location of the patient. Tumor aliquots and nonneoplastic tissues were successfully snap frozen for downstream genomic studies.
Physicians should consider trialing a rapid autopsy program at their institution that could be offered to caregivers of pediatric patients. This case report offers a framework to help clinicians develop their own rapid autopsy programs as well as guidelines to help streamline this process for appropriate candidates going forward.
本研究旨在概述快速尸检程序,以获取高质量的用于基因组分析的死后组织。
本报告详细介绍了一项两机构合作努力,以协调对一名在家中死亡的儿科患者进行快速尸检。我们讨论了向儿科患者的照护者提供快速尸检的科学依据,以及家长对提出尸检主题的看法。然后,我们回顾了规划快速尸检所涉及的后勤和协调工作,以及为最大限度提高组织质量所需的事件顺序。
我们报告了一例成功协调的快速尸检,该患者在其位于州外家中的临终关怀环境中死亡。尽管考虑到患者所在地的后勤因素,但从死亡到快速尸检程序开始的时间间隔为 4.5 小时。肿瘤等分试样和非肿瘤组织成功地进行了速冻,用于下游的基因组研究。
医生应考虑在其机构试行快速尸检计划,该计划可提供给儿科患者的照护者。本病例报告提供了一个框架,帮助临床医生制定自己的快速尸检计划,并为今后适合的候选者提供简化这一过程的指南。