Frozen Vials

1. Frozen Vials Normal & abnormal vials can be designated as such w/different colored caps or by manipulating barcodes.

2. Paraffin Sections • A section of tissue is placed in a cassette and fixed in formalin to create a paraffin block.  • Origin = directly adjacent to frozen section taken from same specimen • “Matched samples” • Stained (H&E) and Unstained Slides • Quality assurance • Diagnosis confirmation • Photography • Archived paraffin retrieval • 10-15 years • Can also create paraffin curls (20μm)

3. TMAs • Tissue Microarray • Many samples, one marker • Lower cost to researchers than gene microarrays.

4. OCTs • Tissue placed in small mold • Embedded in Optimum Cutting Temperature (OCT) compound • Once frozen, cube (“chiclets”) is transferred to an air-tight Cryosette ® to prevent dehydration during storage.  • Label Cryosette ® • Pt. representative ID • Sample ID • Generally cut to match paraffin and frozen sections.

5. Fresh Tissue • Allocate & weigh tissue • Place in correct (pre-marked) vials or self-label tubes • Transport media • Researcher-provided • RPMI w/antibiotic • PBS • Record ischemic time, specimen ID, sample ID, weights, etc. • Package • Notify researcher/send documentation • Pick-up

6. Blood, Blood Products & Other Fluids • Whole Blood • Serum • Plasma • Synovial Fluid • Aspirates • Smears

7. Tissue Banking Operations • Sample Data: • Sample ID • Weight of Sample (frozen tissue) • Ischemic time • Case Data: • Case ID • Top line diagnosis • De-identified Pathology report • Pathology Verification • Tumor vs Lesion vs Normal • Percentage of tumor (when present)

10. Data Tracking w/Excel

11. Tissue Banking Operations • Inventory management Need to develop both physical and database storage systems • A system for all tissue formats • (Blocks, slides, OCT samples, frozen samples, blood and serum samples) Storing options • Cold storage vs. ambient temperature • Storage boxes • Sample vials • Cryosetts or Mega-cassettes • Blood samples • Labeling • Label printers • Label designed for -180 C • Labeling conventions • Bar coding technology

12. Freezer • Storage Temperature: (-80) C • Capacity: • 15360 1.2 ml vials • 5400 OCT Cryosetts

13. Inventory • Tracking Sheets • Bar-coding • Self vs. pre-labeled • Scanner • Excel Spreadsheet • Data transfer • Storage Considerations • Cold Temp. • Ambient Temp.

14. Tissue Banking Operations • Inventory management • Develop a database for all samples in the inventory • Excel or Access databases (home grown systems) • Dedicated tissue banking software programs are available • caBig (NCI) • Gulfstream • Daedalus • Freezer works “free versions” available • Samples need to be both checked in and checked out when withdrawn from inventory

15. Inventory List

16. Tissue Banking Operations • Data Management • Types of pathology and clinical data • Medical records • Pathology reports • Patient interviews • Internal management of pathology reports • What to extract from pathology reports to include with tissue sample • De-identification of pathology reports including names, dates, and case numbers (Software is available for this task). • Clinical Data for Clients • IRB approval of clinical data forms supplied by client. • Extracting information from medical charts vs. patient interviews

17. Tissue Banking Operations • Data Management • Storage of clinical information and Pathology Data • Commercial systems available • Pathology Information Systems • All information should be based on searchable and retrievable data points (not free text)

18. Operations • Equipment needs • Revco (-80 degree Celsius freezer) • Scale (to at least 100 mg) • Label printer with labels that can withstand -180 • Source / storage of liquid nitrogen (Cryoshipper) • Computer / Printer

19. Operations • Personnel requirements / Staffing • What is the scope of the Tissue Banking Program • One man show vs. a full scale operation • What support can come for other departments • Is the tissue bank supporting both internal research, external research or both • Capacity

20. Operations • Financial considerations • Funding possibilities • Hospital commitment to the effort • Pharmaceutical collaborations • Tissue brokers collaborations • Internal research grants / Department support • Academic collaborations • National grants

21. “Tasks” • Determine what case types to bank • Review surgical schedule to identify desirable cases • Meeting and consenting patients • Communication with the OR to identify targeted case and to arrange for timely specimen transport • Handling the tissue/blood (Dividing and processing for various sample formats) • Labeling samples and placing them into an inventory • Maintaining the inventory (Update deposits and withdraws) • Processing of histology blocks • Pathology verification (tumor percent, ischemic time, sample weight) • Develop / purchase a searchable database that can hold case information • Data collection (Pathology report and clinical data retrieval) • De-identification of all patient demographics • Shipping or transporting samples to the researcher • Office responsibilities • Billing management for both external accounts. • Equipment and supply needs

22. Thanks!

23. Contact Information • Mike Jones, MD Principal Investigator jonesm@mmc.org 207-662-2959 • Paul Auclair, DMD • auclap@mmc.org 207-662-4025 • Rocky Ackroyd, Path Ass’t • ackror@mmc.org 207-662-6825 Web Site: www.mmctissuebank.org