Abstract #12

by | Sep 18, 2023 | 2023 Abstracts

Abstract 12- 1400-1415
Category: Clinical

At the end of the session, participants will be able to:

  1. Learn important quality parameters in brain bank tissue
  2. Understand that MAiD patients represent an important source of autopsy brain tissue

COI Disclosure:

None to disclose.

Presenter

Dr. Joseph has been a neuropathologist in Calgary for 16 years and in Boston for 12 years.

Authors

Jeffrey T. Joseph1

Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada

    Target Audience:

    Pathologists, Residents, Medical Students

    CanMEDS:
    Collaborator, Leader, Health Advocate, Scholar

    Death and the MAiD at the Calgary Brain Bank

    Abstract

    Objective: Determine tissue quality parameters in Medical Assistance in Dying (MAiD) brain donations

    Background:  In Canada, Medical Assistance in Dying (MAiD) was decriminalized in 2015 and was legalized in Canada and Alberta in June 2016.

    Methodology: Review 18 brain donations from MAiD patients to the CBB and compare them to non-MAiD donations. Four quality parameters were compared to non-MAiD patients in the CBB: post-mortem interval (PMI), neuronal acidophilia (surrogate marker for hypoxia-ischemia), type 2 astrocytes in the globus pallidus externus (surrogate marker for systemic metabolic derangements), and cerebellar internal granular neuron autolysis (reflection of patient’s pre-mortem medical state, including systemic acidosis).

    Results:

    1. Two procedural changes have brought the PMI from an average of 44 hours to 6 hours in MAiD patients. MAiD patients have a significantly shorter PMI than non-MAiD patients.
    2. Unlike many brain bank patients, who die from non-neurological terminal diseases, most MAiD patients die without significant systemic diseases; they die without undergoing prolonged dying.
    3. MAiD patient brains have no or only early acidophilia in sensitive sites.
    4. MAiD patient brains have no type 2 astrocytes.
    5. MAiD patient cerebellums lack internal granular neuron autolysis.

    Conclusions: MAiD patients represent an important source of autopsy tissue, which circumvents degradation of brain tissue during the dying process that affects many brain banks