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J Med Ethics 2003;29:135-136 doi:10.1136/jme.29.3.135
  • Controversy

Cadaveric tissue donation: a pathologist’s perspective

  1. P J van Diest1,
  2. N W J Lopes Cardoso2,
  3. J Niesing3
  1. 1Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
  2. 2Department of Medical Affairs, VU University Medical Center, Amsterdam, The Netherlands
  3. 3Department of Surgery, University of Groningen, Groningen, The Netherlands
  1. Correspondence to:
 Dr P J van Diest, Professor of Oncological Pathology, Department of Pathology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands; 
 pj.vandiest{at}vumc.nl
  • Accepted 23 March 2003

Cadaveric donation comprises organ donation—that is, taking organs (heart, lungs, kidneys, liver, pancreas) from brain dead people, as well as tissue donation, meaning taking tissues (skin, corneas, tendons, bone) from brain dead as well as heart dead people. The organ transplant procedure from brain dead patients is beyond the scope of the pathologist, as it is done by surgeons in the operating theatre. In a broader sense, however, pathologists are involved in cadaveric tissue donation as well as taking tissues from cadavers for diagnostic procedures within the framework of the autopsy (fluids, organs, tissue samples), and to gather material for research and training students and pathology residents (tissues, organs). For cadaveric tissue donation, different ethical and practical issues must be considered, which we will try to review in this paper from the perspective of the pathologist.

CADAVERIC TISSUE SAMPLING FOR TRANSPLANTATION PURPOSES

Several tissues can be taken from “true” cadavers that may still be used for transplantation such as skin, corneas, tendons, bone. This is usually done in collaboration with the pathologist, who is in most countries responsible for the body after the death of the patient in the hospital. All these tissues can be harvested several hours after death, as they undergo only slow degradation. In The Netherlands, as dictated by law, patients must actively have given permission for donation during life by registering with the Transplantation Register. Since this procedure was implemented, the number of organs available for donation has not increased but decreased somewhat, while the number of tissues has increased. A great obstacle to the increase in the number of donations is that only 37% of the population is registered (as either donor or non donor) …

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