Rapid Autopsy Programs and Research Support: The Pre– and Post–COVID-19 Environments
Rapid Autopsy Programs and Research Support: The Pre– and Post–COVID-19 Environments
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DOI：
10.1097/pcr.0000000000000435
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发表时间：
2021-03-05
期刊：
影响因子：
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通讯作者：
Hooper JE
中科院分区：
文献类型：
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作者：
Hooper JE
每次快速尸检都是一个强大的机会，可以同时为多名研究人员提供许多有价值的组织标本。自从快速尸检开始发展以来，所有快速尸检项目的首要组织原则就是必须尽快取出和处理样本或器官。为了实现这一目标，一些快速尸检程序仅针对一种肿瘤类型，而其他程序则接受表现出所有肿瘤类型甚至其他疾病的患者。快速尸检项目是后勤复杂且劳动密集型的结构；因此，他们成功的关键是项目灵活性和保持多学科关注。临床医生和研究人员之间复杂关系中必要的合作可以分解为所有参与者必须理解、接受和实践的一系列思想和行动步骤。快速尸检的预案步骤（死亡之前）的一个关键部分是研究同意过程。极其重要的是，尸检标本必须获得个体化同意，并且其书面条款必须足够通用，足以用于患有所有类型疾病的患者以及适当范围的未来研究用途。 SARS-CoV-2/COVID-19（严重急性呼吸综合征冠状病毒2/2019冠状病毒病）的出现给尸检病理学领域带来了新的挑战和机遇。必须制定和调整指南和实践，以保护医生和工作人员，同时最大限度地提高诊断率。然而，对死于或患有 COVID-19 的患者进行的任何尸检都是一个独特的机会，有助于了解疾病机制和改进死亡证明，从而有助于临床护理和卫生公共政策的制定。
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 rapid autopsy programs 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 on only 1 tumor type, whereas others accept patients demonstrating all tumor types and sometimes other diseases as well. Rapid autopsy programs 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 precase 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 terms general enough 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 (severe acute respiratory syndrome coronavirus 2/coronavirus disease 2019) 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 the disease mechanisms and to improve death certification, thus assisting in both clinical care and the development of health public policy.