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What is rapid autopsy?

The idea is to obtain tumor tissue immediately after death -- before it has a chance to degrade


Keith Beck , athletic director at the University of Findlay in northwestern Ohio, donated his body to a rapid-autopsy research study at the Ohio State University before he died of bile duct cancer last year.


The 59-year-old had agreed to a "rapid autopsy," a procedure conducted within hours of his death on March 28, 2017, so that scientists could learn as much as possible from the cancer that killed him, CNN reports.

 

To obtain tumour tissue immediately after death


The idea is to obtain tumor tissue immediately after death -- before it has a chance to degrade. Scientists say such samples are the key to understanding the genetics of cancers that spread through the body, thwarting efforts to cure them.


Scientists recognize the value of examining tissue from multiple sites soon after death and obtaining larger samples than they could while a patient was living. Cancer cells can be retrieved during such autopsies and kept alive, allowing researchers to experiment with ways to treat -- or kill -- them.

 

How to preserve RNA and DNA


Speed is essential to preserve RNA and DNA, the building blocks of cells, which can degrade quickly after death. It's best to obtain specimens of living cells within six hours of death and other tissue within 12 hours.

 

In Beck's case, results from the rapid autopsy showed he had developed a mutation that caused the experimental drug he was taking, known as an FGFR inhibitor, to stop working. Roychowdhury and colleagues plan to report on Beck's case in an upcoming paper.

 

Scientists are familiar with rapid-autopsy technology which has been available for decades. 
But only in recent years have more hospitals been launching and expanding programs, said Dr. Jody Hooper, director of the Legacy Gift Rapid Autopsy Program at Johns Hopkins Medicine in Baltimore. At last count, there were 14 similar programs in the U.S.

 

Most programs focus on cancer

 

It's the power of sampling over the entire body at the same time," said Hooper, who conducts about one rapid autopsy a month, often providing tissue for up to a half-dozen researchers interested in different questions.


Most programs focus on cancer, but efforts are underway to expand the practice, possibly to shed light on virus reservoirs in HIV patients, for instance.

 

Patients are eager to cooperate


Broaching the subject with patients and families requires tact and compassion. Most patients are enrolled in clinical trials and learn about the autopsies from their doctors or pathologists like Hooper. Many are willing, even eager, to cooperate, she said.


These are mostly patients with metastatic cancer," she said. "They've made their peace with the outcome long before."


For some, the rapid autopsy is simply the final phase of the clinical trial.

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