Tissue bank

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A tissue bank is an establishment that collects and recovers human cadaver tissue for the purposes of medical research, education and allograft transplantation. A tissue bank may also refer to a location where biomedical tissue is stored under cryogenic conditions and is generally used in a more clinical sense. [1]

Contents

The United States Navy Tissue Bank is generally accepted as the first full tissue banking service of its kind in the world although it is not the largest or only tissue bank today. [2]

Donating a body

Most medical schools need donated bodies for teaching students about the anatomy and physiology of the body, as well as how to perform medical procedures. There are no upper age limits for donating your body to science. Each school has different policies and procedures for donated bodies. [3]

Act 368 of the Public Acts of Michigan 1978, Article 10, Part 101, authorizes an individual to will their body to a medical institution. [4] Medical institutions will only accept a full body, meaning the body cannot be used for organ donation prior to body donation because it would leave the body incomplete. At the time of death, the institution where the body is being donated to should be contacted as soon as possible. The decision to accept or reject the donation will be made at that time. A body could be turned away if it has already begun decomposing, the person was extremely obese, recent surgery was conducted, thoughts of possible contagious disease or severe trauma to the body occurred. There is no an age restriction as long as the donor or the donor’s legal representative gives consent. It is very uncommon for a school to turn down a body due to having an adequate supply; they are always in high demand. At Michigan State University people can choose whether to donate their body for three years or without any restriction as to the length of time. A body donated for an indefinite period can be used for educational purposes as long as it remains an effective teaching tool. At the end of that time the body is cremated and the family's instructions for disposition are followed. [5]

In Brazil, the Brazilian Legal Code allows teaching to be done on cadavers that are unclaimed from the Institutes of Forensic Medicine. [6] This means that if a family does not claim a body, it gets put to use for teaching purposes. The number of cadavers available for teaching has declined in Brazil due to an increasing number of families choosing to claim their relative's body. Many Brazilians are unaware that a body can be voluntarily donated to a university after death, which also contributes to the shortage of cadavers for teaching. [6] In 2008, a program officially started at The Federal University of Health Sciences of Porto Algre making body donation official and also creating terms that the donor must agree to so that the program does not come under legal trouble. [6] This provides the university background information about the donor as well, which may be beneficial to research or use of the body. [6]

In the Netherlands, organ donation and whole body donation are regulated by two separate acts and have distinct differences. The Organ Donation Act regulates organ donation in the Netherlands during life and after death. [7] The Burial and Cremation Act regulates whole body donation. [7] This document states that body donation to science is a third party option of body disposal. Organ donors are actively recruited by the Dutch government whereas body donors are not. [7] A contract must be signed by both the institute and the donor to donate one's body. After organ donation, the body is returned to the family for burial or cremation. Whole body donation uses the entire body and no part of it is returned to the family. Any remains from scientific study are cremated. [7]

Organ Donation

There are different types of body donations that involve different organs. Organ donation and whole body donation are not one and the same. The body needs to be complete in order for many medical institutions to accept the bodies. This means that specific organ donation may not occur before a whole body is donated.[ citation needed ]

Blood, bone marrow, eye, kidney, liver, lung, pancreas, and tissue are acceptable organs for donation. [7] [8] [9]

Willed Body Donation

A Willed Body Donation program is a program that allows people to donate their bodies after death. Most U.S. tissue bank companies get their supply of cadaver tissue through Willed Body Donation programs run by the tissue bank itself. [10]

These programs then charge their customers (mainly medical instrument companies) for services associated with preparation of the cadaver tissue (e.g. transportation, refrigeration, and recovery) rather than charging money for the donated tissue itself, though it is not illegal to do so for non-transplant and or research organizations per the Uniform Anatomical Gift Act as it is for transplant and/or therapy.[ citation needed ]

The American Association of Tissue Banks (AATB) is the most recognized accrediting body for American tissue banks. [2]

At the first European Conference on Problems of Tissue Banking and Clinical Applications, held in Berlin on Oct 24-26, 1991, many European countries joined together to adapt common practices regarding tissue banks and the European Association of Tissue Banks was created. [2]

Commerce

Body brokers are firms or individuals that buy and sell cadaver human body parts for use of research. Trade in these body parts is performed in a manner similar to other raw materials, though many brokers insist they charge fees as opposed to selling body parts. [12]

Procedures

House Bill 4341 was passed in 2014 regarding permission given to all schools in Michigan to receive cadavers for the promotion of education. [13] The medical school must have a mortuary license. The law protects the bodies to be used from anything other than learning purposes. The school has to be credited by the Department of Community Health in order to receive a body and to be able to practice on it. There is a limit to the number of cadavers they have at one point in time at the house. [13]

At the University of Washington, a body may be refused if there are signs of decomposition, severe trauma, infectious diseases, significant bedsores, obesity, jaundice, recent surgeries, or autopsied remains. [14] The University of Washington’s School of Medicine has a continuing need for donated bodies to the Willed Body Program and accepts bodies of ages 18 years and older anywhere and only in the state of Washington. The School of Medicine is to be notified immediately at time of death. If the potential donor family does not call at this time, the donation is cancelled. The family is to be informed of any and all decisions made regarding body donation. When the study is complete, the cremated remains are either buried at the university community plot or are sent to the person on the Donor Registration Form, both at no cost. [9] [14]

Costs

Families will not receive compensation for the body donation. The school will typically pay for cremation costs, transportation costs and embalming. The family takes over cost responsibility of embalming if they request a funeral and the funeral home provides this service. The family is also responsible in making alternate arrangements for final disposition if the donation cannot be completed for reasons previously stated. [14] [15]

Uses

Anatomy is taught in the first year of most medical schools and serves as the foundation for many other courses during a medical student’s education. The donated bodies are used in anatomy labs as a learning tool giving students hands on experience. According to research done, the use of real bodies as opposed to computer stimulation has produced a better understanding of anatomy in students. The research, appearing in Anatomical Sciences Education, compared the use of cadaver based learning and computer based learning of human body structures. This research showed higher scores on anatomy exams for students using cadavers for learning opposed to computer stimulation. [16] Uses for the bodies include teaching other health fields as well, such as nursing or physical therapy. Current physicians use bodies to study new surgical procedures before practicing on live patients. The cadaver should be donated to the nearest medical school and not cross state lines. Faculty, staff, and students of health professions are authorized to use the anatomy lab and outsiders are restricted access. Outside of the medical field, bodies can be used for research to increase safety in military, law enforcement, sports and transportation crashes. [5] [6] [15]

Ethical considerations

There is no common model used between organizations to determine whether utilization of cadaveric images is ethical or not. [17] There is no agreement made with the donor about images being taken or used for any purposes after death so current practice is that the choice is up to the organization in possession of the cadaver. [17] If images of a cadaver were to end up in the wrong hands,[ clarification needed ] there are no laws or guidelines in place as to what can be done with the images. Technology makes up a large portion of information transfer so it is likely that this could happen through hacking or misappropriation of images.[ citation needed ]

In one study published by Clinical Anatomy, doctors unanimously agreed that willed body donations are important for teaching and learning purposes, but only 52% of male doctors consented to donation of their own body and only 29% of female doctors consented. [18] This study found that the actions of doctors while in anatomy labs and other areas where they have been exposed to a cadaver have led them to avoid donating their own bodies.[ citation needed ]

Willed body donation programs do not always run smoothly, as is evident in the 2004 case against UCLA for distribution of body parts to other companies under the pretense that they had already been tested for infectious diseases. [19] Specifically, Johnson & Johnson was purchasing body parts from the director of UCLA’s willed body program at a steep price. The representative from Johnson & Johnson claimed that he had no reason to suspect that the body parts were distributed to him illegally. [19]

Related Research Articles

<span class="mw-page-title-main">Anatomy</span> Study of the structure of organisms and their parts

Anatomy is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having its beginnings in prehistoric times. Anatomy is inherently tied to developmental biology, embryology, comparative anatomy, evolutionary biology, and phylogeny, as these are the processes by which anatomy is generated, both over immediate and long-term timescales. Anatomy and physiology, which study the structure and function of organisms and their parts respectively, make a natural pair of related disciplines, and are often studied together. Human anatomy is one of the essential basic sciences that are applied in medicine.

<span class="mw-page-title-main">Organ donation</span> Process of voluntarily giving away organs

Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin.

<span class="mw-page-title-main">History of anatomy</span> Aspect of history

The history of anatomy extends from the earliest examinations of sacrificial victims to the sophisticated analyses of the body performed by modern anatomists and scientists. Written descriptions of human organs and parts can be traced back thousands of years to ancient Egyptian papyri, where attention to the body was necessitated by their highly elaborate burial practices.

<i>Body Worlds</i> Exhibition of plastinated bodies

Body Worlds is a traveling exposition of dissected human bodies, animals, and other anatomical structures of the body that have been preserved through the process of plastination. Gunther von Hagens developed the preservation process which "unite[s] subtle anatomy and modern polymer chemistry", in the late 1970s.

<span class="mw-page-title-main">Organ transplantation</span> Medical procedure in which an organ is removed from one body and placed in the body of a recipient

Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

The Uniform Anatomical Gift Act (UAGA), and its periodic revisions, is one of the Uniform Acts drafted by the National Conference of Commissioners on Uniform State Laws (NCCUSL), also known as the Uniform Law Commission (ULC), in the United States with the intention of harmonizing state laws between the states.

<span class="mw-page-title-main">Plastination</span> Technique used in anatomy to preserve bodies or body parts

Plastination is a technique or process used in anatomy to preserve bodies or body parts, first developed by Gunther von Hagens in 1977. The water and fat are replaced by certain plastics, yielding specimens that can be touched, do not smell or decay, and even retain most properties of the original sample.

<span class="mw-page-title-main">Visible Human Project</span>

The Visible Human Project is an effort to create a detailed data set of cross-sectional photographs of the human body, in order to facilitate anatomy visualization applications. It is used as a tool for the progression of medical findings, in which these findings link anatomy to its audiences. A male and a female cadaver were cut into thin slices, which were then photographed and digitized. The project is run by the U.S. National Library of Medicine (NLM) under the direction of Michael J. Ackerman. Planning began in 1986; the data set of the male was completed in November 1994 and the one of the female in November 1995. The project can be viewed today at the NLM in Bethesda, Maryland. There are currently efforts to repeat this project with higher resolution images but only with parts of the body instead of a cadaver.

<span class="mw-page-title-main">Dissection</span> Cutting procedure used in anatomy

Dissection is the dismembering of the body of a deceased animal or plant to study its anatomical structure. Autopsy is used in pathology and forensic medicine to determine the cause of death in humans. Less extensive dissection of plants and smaller animals preserved in a formaldehyde solution is typically carried out or demonstrated in biology and natural science classes in middle school and high school, while extensive dissections of cadavers of adults and children, both fresh and preserved are carried out by medical students in medical schools as a part of the teaching in subjects such as anatomy, pathology and forensic medicine. Consequently, dissection is typically conducted in a morgue or in an anatomy lab.

<span class="mw-page-title-main">Body snatching</span> Secret removal of corpses from burial sites

Body snatching is the illicit removal of corpses from graves, morgues, and other burial sites. Body snatching is distinct from the act of grave robbery as grave robbing does not explicitly involve the removal of the corpse, but rather theft from the burial site itself. The term 'body snatching' most commonly refers to the removal and sale of corpses primarily for the purpose of dissection or anatomy lectures in medical schools. The term was coined primarily in regard to cases in the United Kingdom and United States throughout the 17th, 18th, and 19th centuries. However, there have been cases of body snatching in many countries, with the first recorded case dating back to 1319 in Bologna, Italy.

Eye banks recover, prepare and deliver donated eyes for cornea transplants and research. The first successful cornea transplant was performed in 1905 and the first eye bank was founded in 1944. Currently, in the United States, eye banks provide tissue for over 80,000 cornea transplants each year to treat conditions such as keratoconus and corneal scarring. In some cases, the white of the eye (sclera) is used to surgically repair recipient eyes. Unlike other organs and tissues, corneas are in adequate supply for transplants in the United States, and excess tissue is exported internationally, where there are shortages in many countries, due to greater demand and a less-developed eye banking infrastructure.

<span class="mw-page-title-main">Body donation</span> Gifts of bodies for research and education

Body donation, anatomical donation, or body bequest is the donation of a whole body after death for research and education. There is usually no cost to donate a body to science; donation programs will often provide a stipend and/or cover the cost of cremation or burial once a donated cadaver has served its purpose and is returned to the family for interment.

Murder for body parts also known as medicine murder refers to the killing of a human being in order to excise body parts to use as medicine or purposes in witchcraft. Medicine murder is viewed as the obtaining of an item or items from a corpse to be used in traditional medicine. Its practice occurs primarily in sub-equatorial Africa.

<span class="mw-page-title-main">Cadaver</span> Dead body used for study or instruction

A cadaver or corpse is a dead human body. Cadavers are used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Students in medical school study and dissect cadavers as a part of their education. Others who study cadavers include archaeologists and arts students. In addition, a cadaver may be used in the development and evaluation of surgical instruments.

Organ trade is the trading of human organs, tissues, or other body products, usually for transplantation. According to the World Health Organization (WHO), organ trade is a commercial transplantation where there is a profit, or transplantations that occur outside of national medical systems. There is a global need or demand for healthy body parts for transplantation, which exceeds the numbers available.

A beating heart cadaver is a body that is pronounced dead in all medical and legal definitions, connected to a medical ventilator, and retains cardio-pulmonary functions. This keeps the organs of the body, including the heart, functioning and alive. As a result, the period of time in which the organs may be used for transplantation is extended. The heart contains pacemaker cells that will cause it to continue beating even when a patient is brain-dead. Other organs in the body do not have this capability and need the brain to be functioning to send signals to the organs to carry out their functions. A beating heart cadaver requires a ventilator to provide oxygen to its blood, but the heart will continue to beat on its own even in the absence of brain activity. This allows organs to be preserved for a longer period of time in the case of a transplant or donation. A small number of cases in recent years indicate that it can also be implemented for a brain-dead pregnant woman to reach the full term of her pregnancy. There is an advantage to beating heart cadaver organ donation because doctors are able to see the vitals of the organs and tell if they are stable and functioning before transplanting to an ailing patient. This is not possible in a donation from someone pronounced dead.

Several authors have used the terms organ gifting and "tissue gifting" to describe processes behind organ and tissue transfers that are not captured by more traditional terms such as donation and transplantation. The concept of "gift of life" in the U.S. refers to the fact that "transplantable organs must be given willingly, unselfishly, and anonymously, and any money that is exchanged is to be perceived as solely for operational costs, but never for the organs themselves". "Organ gifting" is proposed to contrast with organ commodification. The maintenance of a spirit of altruism in this context has been interpreted by some as a mechanism through which the economic relations behind organ/tissue production, distribution, and consumption can be disguised. Organ/tissue gifting differs from commodification in the sense that anonymity and social trust are emphasized to reduce the offer and request of monetary compensation. It is reasoned that the implementation of the gift-giving analogy to organ transactions shows greater respect for the diseased body, honors the donor, and transforms the transaction into a morally acceptable and desirable act that is borne out of voluntarism and altruism.

Organ donation is when a person gives their organs after they die to someone in need of new organs. Transplantation is the process of transplanting the organs donated into another person. This process extends the life expectancy of a person suffering from organ failure. The number of patients requiring organ transplants outweighs the number of donor organs available.

A body broker is a firm or an individual that buys and sells cadavers or human body parts.

Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994. The law allows both deceased and living donors to donate their organs. It also identifies brain death as a form of death. The National Organ and Tissue Transplant Organisation (NOTTO) functions as the apex body for activities of relating to procurement, allotment and distribution of organs in the country.

References

  1. ↑ Narayan, R. P. (May–August 2012). "Development of tissue bank". Indian Journal of Plastic Surgery. 45 (2): 396–402. doi: 10.4103/0970-0358.101326 . PMC   3495391 . PMID   23162240.
  2. 1 2 3 4 "History of the European Association of Tissue Banks (EATB)" (PDF).
  3. ↑ Sprague, Mildred (September–October 2004). "Donating your body for medical research". Saturday Evening Post (General OneFile): 94. Retrieved 23 April 2017.
  4. ↑ "REVISED MICHIGAN ANATOMICAL GIFT LAW – ABRIDGED PROVISIONS". University of Michigan Medical School. 2018-12-18.
  5. 1 2 "Anatomical Donations Program." University of Michigan Anatomical Donations. N.p., n.d. Web. 20 Mar. 2017.
  6. 1 2 3 4 5 da Rocha, Andrea Oxley (November 26, 2012). "The body donation program at the Federal University of Health Sciences of Porto Alegre: A successful experience in Brazil". Anatomical Sciences Education. 6 (3): 199–204. doi:10.1002/ase.1335. PMID   23184541. S2CID   205434735.
  7. 1 2 3 4 5 Bolt, Sophie (July 11, 2011). "Anatomist on the dissecting table? Dutch anatomical professionals' views on body donation". Clinical Anatomy. 25 (2): 168–175. doi:10.1002/ca.21215. PMID   21748808. S2CID   12489368.
  8. ↑ Greitens, Eric R., Gov. "Donation Types." Missouri Department of Health & Senior Services. N.p., n.d. Web. 19 Mar. 2017.
  9. 1 2 Lori, Matt, Rep. "MEDICAL SCHOOLS: CADAVERS FOR SCIENTIFIC USES." N.p., n.d. Web. 20 Mar. 2017.
  10. ↑ Pimay, Jean-Paul (May 2015). "Access to human tissues for research and product development". EMBO Reports. 16 (5): 557–562. doi:10.15252/embr.201540070. PMC   4428037 . PMID   25851645.
  11. 1 2 3 4 Phillips, Glyn O (December 14, 1991). "Tissue banks in Europe". The Lancet. 338 (8781): 1514–1515. doi:10.1016/0140-6736(91)92319-W. S2CID   54364794.
  12. ↑ In the U.S. market for human bodies, almost anyone can dissect and sell the dead, Reuters, Brian Grow and John Shiffman, 25 October 2017
  13. 1 2 "[Title]". www.Legislature.mi.gov. Retrieved April 23, 2017.
  14. 1 2 3 Montgomery, Mavis Carpio. "Willed Body Information Letter" (PDF). University of Washington School of Medicine.
  15. 1 2 "Willed Body Program." Willed Body Program | Division of Human Anatomy | Michigan State University. N.p., n.d. Web. 19 Mar. 2017.
  16. ↑ University, Michigan State. "Cadavers Beat Computers for Learning Anatomy." MSUToday. N.p., n.d. Web. 23 Apr. 2017.
  17. 1 2 Aneja, Prachi Saffar, Savita Bansal, Kuldip Singh Sood, and Amit Saxena. "Body Donation- A Dilemma Among Doctors". Journal of Evolution of Medical and Dental Sciences 2.16 (2013): 2585–593. Retrieved 13 September 2021.{{cite web}}: CS1 maint: multiple names: authors list (link)
  18. ↑ Cornwall Jon, Callahan David, Wee Richman (2015). "Ethical issues surrounding the use of images from donated cadavers in the anatomical sciences". Clinical Anatomy. 29 (1): 30–36. doi:10.1002/ca.22644. PMID   26474731. S2CID   25109902.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  19. 1 2 Ling Amy (2004). "UCLA Willed Body Program Comes Under Scrutiny as Companies Sued for the Purchase Of Body Parts". The Journal of Law, Medicine & Ethics. 32 (3): 532–4. doi:10.1111/j.1748-720x.2004.tb00168.x. PMID   15490601. S2CID   28115819.
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