Abstract Details

Title The Successful Implementation of a TBI Brain Donation Pathway

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-054

Objective

Recognizing the challenges and potential of neuropathological studies, we provide recommendations for best practices in obtaining brain tissue specimens for research after TBI. This is demonstrated through case review, detailing the steps from consent to brain procurement, and the associated challenges.

Background

In order to appropriately address the pathophysiological inquiries surrounding traumatic brain injury (TBI), a large collection of well-characterized brain tissue specimens is necessary. With autopsy rates declining worldwide, obtaining these specimens is increasingly challenging, placing an additional barrier to progress in the TBI field.

The multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study, in collaboration with the NIH NeuroBioBank, has implemented procedures for obtaining post-mortem brain tissue from subjects who were enrolled in the study while alive, with the goal of increasing the amount of brain tissue specimens available to researchers. These patients have a large amount of clinical information and biological samples already collected as a part of the trial, which makes the brains even more valuable to the research community. As of September 2018, 2,804 TBI patients have been enrolled in the study, with 134 deaths. Of these deaths, 11 brains have been donated at the 11 sites participating in the brain donation aspect of the study (8.2%). These specimens are stored at NIH NeuroBioBank sites (University of Miami Brain Endowment Bank, University of Maryland Brain and Tissue Bank, Harvard Brain Tissue Resource Center, and The Human Brain and Spinal Fluid Resource Center). Preliminary ex-vivo imaging and neuropathological analyses identify pericontusional and multifocal axonal injury, vascular injury, demyelination, and neuroinflammation as prominent pathologic findings associated with neuroimaging abnormalities.

Design/Methods Case review

Results N/A

Conclusions N/A

Authors/Disclosures
Erika Silverman (University of Pennsylvania) PRESENTER	Ms. Silverman has nothing to disclose.
Brian Edlow, MD	Dr. Edlow has received research support from NIH.
Carol Moore (Henry Jackson Foundation/USUHS)	No disclosure on file
Daniel P. Perl, MD (Uniformed Services University of the Health Sciences)	No disclosure on file
Kimbra L. Kenney, MD, FAAN	Dr. Kenney has nothing to disclose.
	No disclosure on file
Danielle Sandsmark, MD	The institution of Dr. Sandsmark has received research support from NINDS. The institution of Dr. Sandsmark has received research support from BrainBox Solutions Inc. The institution of Dr. Sandsmark has received research support from Department of Defense.
Geoffrey Manley, MD, PhD (UCSF Med Ctr/Dept of Neurosurgery)	The institution of Dr. Manley has received research support from NIH-NINDS. The institution of Dr. Manley has received research support from US Department of Defense. The institution of Dr. Manley has received research support from US Department of Defense/MTEC. The institution of Dr. Manley has received research support from One Mind. The institution of Dr. Manley has received research support from Neurotrauma Sciences, LLC. The institution of Dr. Manley has received research support from NFL Scientific Advisory Board.
Ramon R. Diaz-Arrastia, MD, PhD, FAAN (University of Pennsylvania)	Dr. Diaz-Arrastia has stock in BrainBox, LLC. Dr. Diaz-Arrastia has stock in Nia Therpeutics. The institution of Dr. Diaz-Arrastia has received research support from National Institutes of Health. The institution of Dr. Diaz-Arrastia has received research support from Department of Defense.
Megan T. Moyer, NP	No disclosure on file

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