Tissue Recovery

Question 1

Two types of Tissue Recovery

Answer 1

Beating Heart and non beating heart

Question 2

Beating Heart

Answer 2

Clinically dead
Vital functions kept going artificially
Irreversible brain stem damage
Persistent vegetative state [cortex/grey matter]
Hospital Op room
Meds were given after “brain death”: e.g., narcotics, pressure agents
Multiple teams
Multiple “live organs”

Question 3

Non- beating heart

Answer 3

Non-healthcare facility
Bone, skin, vasculature, corneas

Question 4

Multiple Medications given during hospital stay

Answer 4

Get blood samples from when the patient was admitted but
Check times on tubes/medical records

Question 5

Limited Sample due to Procurement

Answer 5

Tissue procurement may limit the sample size available
Small amount of blood collected
Generally educational issue: clinical vs forensic
Children
Increase in postmortem interval
Sample collection at the time of procurement
Chain of custody
Documentation: unknown anatomical site
No solid organs
Liver etc.

Question 6

Position of NAME

Answer 6

procurement of organs and/or tissues for transplantation can be accomplished in virtually all cases without detriment to evidence collection, postmortem examination, determination of cause and manner of death, or the conducting or criminal or civil legal proceedings

Question 7

Isopropanol Contamination Due to Corneal Procurement

Answer 7

Tissue procurement agencies may wash the decedent or the field around the area for procurement with isopropanol
Contamination may result from puncture of the skin or scleral surface prior to complete drying of the isopropanol or passive diffusion into vitreous
Vitreous IPA 0.10% g% - Blood IPA ND
Acetone ND in both specimens

Question 8

Papaverine as a Post-Mortem Artifact

Answer 8

Alkaloid present in opium at about 1%
Clinically - vasodilatory and antispasmodic [0.1-0.4 mg/L)

Question 9

Papaverine saphenous leg vein harvesting

Answer 9

Bolus of papaverine in saline is used to push out the blood in the veins during the procedure, prior to their removal
Acts as a calcium channel blocker, helps preserve the integrity of the venous graft tissue prior to use
Study : 9mg/L found

Question 10

American Association of tissue bank changes

Answer 10

Deletes secretion re: “amending” the flushing solution with an appropriate smooth muscle relaxant (i.e., papaverine)
Current: the sterile isotonic solution may also contain an antithrombotic agent (i.e., sodium heparin)

Question 11

Liver Transplant

Answer 11

Unusual source of toxicity in the recipient
Liver donor died of amitriptyline OD
29-year-old female
Post-op/transplantation
Cardiac arrhythmias
Decreased mental status
Obtunded – resp to pain only
Re-transplantation ]6 days later]
Within 24 hours awake
Cardiac function stable; no arrhythmias
Toxicology
Recipient serum [after original transplantation]:
Pos – ami/nortrp
Original transplanted liver: 6 days post-transplant:
Pos – ami/nortrp