Principles and practice of 'high risk' brain banking

The storage of tissues obtained from patients with clinically documented and neuropathologically validated diseases of the central nervous system (CNS), and from well-chosen control cases, forms a valuable resource for present and future research needs. In particular, it facilitates immediate application of new investigative technology as this becomes available. To maximize their usefulness it is desirable to store tissues in a variety of different forms. including fixed and frozen samples. However, storage of infective dementias poses special problems (including risk to future users) since the infective agent may well survive long-term storage at -70 degrees C. Guidelines for optimal storage of such tissues should conform with safety, but should nest be so prescriptive as to deter pathologists who do not have access to sophisticated brain banking resources. This article provides information about tissue storage from infective CNS diseases for pathologists who may require to retain frozen and other samples from such autopsies either occasionally or on a regular basis, Guidelines are offered for banking tissues from cases infected with human immunodeficiency virus (HIV), hepatitis viruses and prions, with detailed description of procedures for acquisition, storage and transport of high-risk samples. Safety issues and protocols for response to accidental injury involving exposure to these agents are highlighted in this article.