Hooper Jody E
Department of Pathology, The Johns Hopkins University, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
AJSP Rev Rep. 2021 Mar-Apr;26(2):100-107.
Each rapid autopsy is a powerful opportunity to supply multiple researchers with many valuable tissue specimens at the same time. Since the beginning of the development of rapid autopsy, the overriding organizing principle for all RAPs has been that the samples or organs must be removed and processed as rapidly as possible. To accomplish this some rapid autopsy programs are focused just on one tumor type, while others accept patients demonstrating all tumor types and sometimes other diseases as well. RAPs are logistically complicated and labor-intensive structures, therefore, the key to their success is program flexibility and maintaining a multidisciplinary focus. The necessary collaborations in the complex relationships between clinicians and researchers can be broken down into a series of thought and action steps that must be understood, accepted, and practiced by all participants. A crucial part of the pre-case steps (prior to death) for a rapid autopsy is the study consenting process. It is extremely important that this individualized consent is obtained for postmortem specimens and that it is written in general enough terms to be used for patients with all types of diseases and for an appropriate range of future research uses. The advent of Sars-CoV-2/COVID-19 has presented new challenges and opportunities to the field of autopsy pathology. Guidelines and practice had to be created and adapted to protect physicians and staff while maximizing diagnostic yield. However, any autopsy performed on a patient dying of or with COVID-19 represents a unique opportunity to contribute to understanding of disease mechanisms and to improve death certification, thus assisting in both clinical care and the development of health public policy.
每一次快速尸检都是一个向多名研究人员同时提供许多有价值组织标本的有力契机。自快速尸检开展以来，所有快速尸检项目的首要组织原则一直都是必须尽快取出并处理样本或器官。为实现这一点，一些快速尸检项目仅专注于一种肿瘤类型，而其他项目则接收患有所有肿瘤类型以及有时还患有其他疾病的患者。快速尸检项目在后勤方面很复杂，且劳动强度大，因此，其成功的关键在于项目的灵活性以及保持多学科重点。临床医生与研究人员之间复杂关系中必要的合作可细分为一系列所有参与者都必须理解、接受并践行的思维和行动步骤。快速尸检的病例前步骤（死亡前）中的一个关键部分是研究同意过程。对于死后标本获得这种个性化同意极其重要，并且其措辞应足够宽泛，以便用于患有所有类型疾病的患者以及适用于未来一系列适当的研究用途。严重急性呼吸综合征冠状病毒2/新冠肺炎的出现给尸检病理学领域带来了新的挑战和机遇。必须制定并调整指南和做法，以保护医生和工作人员，同时使诊断产出最大化。然而，对死于新冠肺炎或患有新冠肺炎的患者进行的任何尸检都是一个独特的契机，有助于了解疾病机制并改进死亡证明，从而为临床护理和卫生公共政策的制定提供帮助。
