The human body is made up of billions of cells that are grouped together and organized based on structure and function. Examples of tissue types include epithelial tissue, muscle tissue, nervous tissue, and connective tissue. Organ or tissue procurement is a process where the specimens or organs are collected to help support research or to help save another life. The process is complex and often involves various medical professionals in different settings. Both state and federal legislation has been enacted to help maintain the efficiency and fairness of the process. This process helps ensure that the donated organs for transplant and tissue for research are equally distributed. The donation of organs can save lives. However, the need for donated organs has always far exceeded the number of organs donated. Therefore, to ensure that a fair and efficient process, the National Organ Procurement and Transplantation Network (OPTN) was established. This organization also helps to match donor organs to potential recipients. OPTN is managed by the United Network for Organ Sharing (UNOS). UNOS works closely with various organ procurement organizations to place the donated organs locally, regionally, and nationally.
Organ / Tissue Procurement Procedure
This describes the steps for organ procurement:
A potential donor is identified based on several criteria: brain death, age limits, and absence of systemic infections or extra-cerebral malignancies.
The local organ procurement organization confirms the suitability of the donor.
Brain death is declared in accordance with the law.
The organ procurement organization evaluates the potential donor’s history and physical examination.
The donor’s next of kin will sign a consent form.
The donor will then be maintained medically once brain death has been declared.
Surgical transplant teams will arrive and depart based on a schedule. These teams usually consist of operating room clinicians, surgeons, or an organ or tissue preservationist.
Once the surgical teams have arrived, surgery begins.
After the organs and tissues have been procured, the body is prepared according to hospital guidelines. There will be no change in the appearance of the body which allows the option for open casket funerals.
Donor organs are matched with tissue typing procedure taking about 6 hours. Besides tissue type, other criteria that have to be met include blood type, waiting time on the list, percent of reactive antibody, medical urgency, and distance of organs from the transplant center.
Once the recipient is identified, pre-operative workups are required.
The donated organs or tissues are distributed to the centers where preservation or transplant will occur.
Surgery is performed.
The procurement organization will also be responsible for follow-ups which may include letters to the donor's family, physician, and nurses about the donor organs and tissue.
Tissue Procurement Processing and Preservation
For tissues donated for research purposes, these biospecimens can be fixed using formalin or snap frozen to preserve the DNA, RNA, and proteins in the specimen. This minimizes the denaturation of the tissue. It is then sent to laboratories where it is processed and stored appropriately. For example, some biospecimens can be formalin-fixed paraffin-embedded samples. These samples can be stored at room temperature for many years. Another method is freezing the specimens using liquid nitrogen and storing it in specialized freezers which maintain the temperature required for storage. The quality of the specimens is reviewed by a certified pathologist. These specimens are also assigned a unique identification for easier retrieval when required. The information associated with the biospecimen is also recorded in the laboratory information management system. It usually includes information such as gender, age, and other clinical data.
Tissue Procurement Objectives
Human organs and tissues are critical in modern medicine as it is vital in the research process to ensure efficacy and safety of new procedures and treatment for everyone. Research involving these specimens can also help in the improvement of diagnosis and prediction of disease progression. For example, to develop a treatment for cystic fibrosis, researchers observed the movement of cilia in lung tissue when injected with different medication. In the United States, tissue procurement from donors is important as the supply from private research facilities can be finite and limited. Some of the services provided by various biomedical entrepreneurs include:
The collection and storage of diseased or normal tissue from surgery or autopsy.
Providing fresh tissue (such as tumor tissue) for cell studies.
Processing and banking of biospecimens (such as blood) from cancer patients.
The maintenance of a tissue database that has links to clinicopathological data.
Providing pathological review and histological staining of biospecimens.
Coordination of consent from donors and assuring them regarding regulatory compliance.
Human tissue procurement allows maximizing the access of human tissues to researchers.
Tissue and organ procurement are both important as it helps in saving lives and advancement of the medical field. In research, tissue procurement helps researchers to develop new tests for diagnoses of diseases, treatment for existing diseases, and testing the safety and efficacy of drugs before it is distributed for public use. It leads to new discoveries and possible improvement of healthcare for everyone.
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Why human tissue procurement is so important. Geneticist. Accessed 6/6/2019. https://www.geneticistinc.com/blog/why-human-tissue-procurement-is-so-important
Tissue procurement. Cancer Institute. Accessed 6/6/2019. http://med.stanford.edu/cancer/research/shared-resources/tissue-procurement.html