Rapid Autopsy Programs and Research Support: The Pre- and Post-COVID-19 Environments

Abstract

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.

Keywords: COVID-19; autopsy; cancer research; postmortem; rapid autopsy.

Figure 1.. Planning and Action Steps by RAP Director and Researcher for a Successful Rapid Autopsy Collaboration

This Figure was adapted by permission from Springer Nature: Performance of Rapid Research Autopsy, Hooper JE, Duregon E in Autopsy in the 21^st Century by Hooper JE, Williamson AK, Eds., 2019.

Figure 2.. Suggested Post Mortem Interval Guidelines for Effective RAP Tissue Sample Utilization

This Figure was reprinted by permission from Springer Nature: Performance of Rapid Research Autopsy, Hooper JE, Duregon E in Autopsy in the 21^st Century by Hooper JE, Williamson AK, Eds., 2019.