By Elizabeth Lesko
Most people are familiar with the concept of donating your body to science – the cadavers used to teach medical students must come from somewhere after all – yet few have given much thought to exactly how one goes about donating their body. Adults in the United States likely remember being asked to opt in as an organ donor when they receive or renew their driver’s license but, in general, give little consideration to the milieu involved in organ donation. Luckily, some generous donors have thought outside of the organ donor check box and have generated resources to help others donate their earthly remains for the benefit of research, medicine, and education. Today I will take you through some of these resources and explain how one goes about donating their body to science.
Whole Body Donation – Educating Future Doctors
This category of body donation is probably the first that springs to mind when considering post-mortem donation. The practice of using cadavers as a teaching tool goes back centuries, however, the practice of civilians willingly making this choice has a much shorter history. The modern protocol for cadaver donation is meant to ensure donations occur in an ethical manner and requires the individual to sign a series of legal documents declaring their desire to be used as a teaching tool for training medical students. The process for whole body donation varies by state; here in Pennsylvania, residents must fill out and submit a donor form to the Human Gifts Registry in order to donate their remains for cadaveric dissection at any of the nine member schools, which includes our own Penn State College of Medicine.
There are some considerations that must be made before deciding if whole body donation is a contribution you wish to make. It should be noted that the typical donation process (at least in PA) ends in cremation and anonymous interment at one of the Humanity Gifts Registry cemeteries. While special requests may be made by the next of kin for return of the cremains for private burial, it can take more than two years for the remains to be returned.2 Dissection or cremation may conflict with cultural or religious beliefs regarding treatment of the deceased, which could be an important consideration for the donor and their next of kin. However, if these prospects do not affect your decision to donate, the actual donation is a rather straightforward and secure method of donating to science. Any adult can donate their body to medical education with very few restrictions, and in some cases organ donors can give a whole-body donation in addition to donating certain organs. Funerary and most body transport costs are covered by the medical school and in many locations – including PA – memorial services are held by the medical schools each year to commemorate those who have gifted their body to medical education. Overall, this method of furthering medicine and science is worthy of some serious contemplation.
Organ Donation – From Bone to Brain
When you opt-in to be an organ donor on your driver’s license, this consent only covers typical organ, eye, and tissue donation of eligible individuals for transplant. One can opt-in to Vascularized Composite Allograft (e.g. face or hand transplant) donation via a separate authorization process that is federally required due to the nature of the donated material.3.4 Qualifying causes of death for posthumous organ donations intended for transplant are limited to a subset of cardiac and neurological causes5, reducing the probability that one will qualify as a donor. Ensuring that you are opted-in as an organ donor is an important and valuable way to contribute to life-saving medical practices, but what if you want to donate a specific organ for a specific purpose – say, your brain for neurological research?
As it turns out, donating your brain to neurological research is a clear-cut process similar to whole body donation. In the United States, the National Institutes of Health runs a network of brain banks known as the NeuroBrainBank, and individuals can either reach out to a brain bank in this network or, more simply, pre-register through a service such as the Brain Donor Project to be connected with an appropriate location.6 The individual then needs only to fill out the forms given to them by their brain bank to register. This avenue of donation warrants special consideration from individuals with known neurological conditions such as Alzheimer’s Disease or other dementias whose donation could help research into the pathology and treatment of neurological disorders.7 For those with interests in other organ diseases, there is likely a tissue bank for the corresponding organ where you can register to donate – the Health Resources & Services Administration is a good starting point. If you have a medical condition and wish to contribute your bodily tissues to research in that area, I encourage you to look into registering to donate through a tissue bank – these organizations often provide tissue samples to multiple research labs, ensuring your donation provides as much knowledge as possible. If you don’t have a medical condition, I still encourage you to look into donation! Good research on any disorder requires healthy control samples, and donation of healthy material can also benefit more fundamental research on how the human body functions.
Living Donations – Blood, Biopsies, and Bone Marrow
Thus far I’ve discussed multiple methods in which you can ensure the post-mortem donation of your body, organs, or tissues to medicine or research, but there is also an entire category of living donation. For those interested in donating tissue samples to research there are a number of different ways to help. Material collected during surgery can primarily be donated in one of two ways: pre-surgery registration with donor organizations or by giving consent for your tissue to be used for research by hospital-connected labs. The first method is the best way to ensure your tissue will be put to use in research, and resources such as the National Disease Research Interchange can help potential donors through this process. The second method is more common in cases where biomedical research labs are connected to hospitals that regularly obtain samples that are useful for their research interests. For instance, parents of infants undergoing circumcision or patients undergoing breast reduction surgery may be requested to donate the skin tissue removed during the procedure to research labs connected with the hospital’s dermatology department.
Which brings us to the last type of body donation I will cover here: donating blood, bone marrow, or organs for living transplant. Living organ donation is a highly specific situation that typically involves a prior connection between the donor and recipient, e.g. a person donating a kidney to their close relative. Blood donation, on the other hand, is a very easy and extremely valuable method to contribute to medicine and research and is most commonly handled by the American Red Cross. For individuals wishing to donate their blood plasma specifically for research purposes, there are many locations that perform this service which can be easily found by searching for plasma donation centers in your area.
Bone marrow donation falls into a unique category between organ and blood donation. Transplantation of bone marrow following radiation therapy is a common method of treating cancers of the blood. Much like other forms of organ transplant, bone marrow transplant requires a high level of similarity at many genetic loci in order to successfully grow in the recipient’s body. Unlike most other forms of organ donation, however, the donor can give enough bone marrow to transplant without losing any function themselves and so can donate with limited risk. Organizations such as Be the Match allow individuals to join the bone marrow registry, where that individual’s genetic information will be compared to patients and, upon a match, a donation can be given to save a life.8
While I hope that I’ve managed to provide a thorough overview of what is involved in the process of donating your body to science from the donor’s end, I’ve barely scratched the surface on what a donation means to the recipient. Hospitals rely on the donation of blood, tissue, and organs to perform life-saving procedures on a daily basis, while scientists rely on valuable tissue samples to provide the all-important human data for research on every topic in medicine. Whole body donation to medical schools provides immeasurable educational value in training future medical professionals. No matter the application, donating your body to science is a selfless and invaluable deed that deserves to be a larger and less mysterious part of the conversation in medical research.
Sources:
1. Mary Shelley. “Frankenstein at work in his laboratory”. Frankenstein, 1922, 7. Wikimedia commons, https://commons.wikimedia.org/wiki/File:Frankenstein,_pg_7.jpg
2. Humanity Gifts Registry. FAQ. Philadelphia, PA. 2021. http://www.hgrpa.org/faq
3. Pennsylvania Department of Health. Organ Donation. 2021. https://www.health.pa.gov/topics/programs/Organ%20Donation/Pages/Organ%20Donation.aspx
4. PennDOT Driver & Vehicle Services. Organ and Tissue Donation. 2021. https://www.dmv.pa.gov/Driver-Services/Driver-Information/Pages/Organ-Donation.aspx
5. Center for Organ Recovery & Education. Donation process. 2018. https://www.core.org/understanding-donation/donation-process/
6. Brain Donor Project. What to Expect. https://braindonorproject.org/what-to-expect/
7. National Institute on Aging. Brain Donation Resources for ADRCs. https://www.nia.nih.gov/health/brain-donation-resources-adrcs#faq
8. Be the Match. FAQs about joining. 2021. https://bethematch.org/support-the-cause/donate-bone-marrow/join-the-marrow-registry/faqs-about-joining/
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