Mayo Clinic Jacksonville Brain and Spinal Cord Protocol

Thank you for enabling us to establish a diagnosis of neurological disease and to obtain tissue for special studies and research in neurological diseases.  Most likely you have been directed to this webpage because there is a desire to collect both the brain and spinal cord for research. For example, research into amyotrophic lateral sclerosis (ALS) requires both brain and spinal cord.

Mayo Clinic Jacksonville – Brain and Spinal Cord Recovery Protocol

Please perform the harvest as soon as possible after death, preferably within 12 hours (up to 24 hours is still acceptable). The time lapse between death and autopsy should be noted as well as the fresh brain weight when drained of CSF.

Split the brain down the middle through the corpus callosum, cerebellar vermis and brainstem. Put the right hemisphere in a plastic bag into the coldest possible freezer (preferably at -70˚C). In order to prevent distortion of the specimen, put the medial aspect of the brain down flat, so that it will freeze in its normal shape. The left hemibrain is simply immersed in formalin, buffered to neutrality.

Split the spinal cord down the middle. Then cut each half into three sections – cervical, thoracic, and lumbar. Put the three sections from the right half in three separate plastic bags and place those bags into the coldest possible freezer (preferably at -70˚C). Put the three sections from the left half in formalin, buffered to neutrality.


Mayo Clinic Jacksonville – Shipping Instructions

When ready to ship, the frozen specimen is packed in 48 hours worth of dry ice in a Styrofoam shipping container. The formalin fixed specimen is wrapped in paper towels that are damp with formalin, put into a leak-proof plastic bag in a separate shipping container, wrapped separately from the frozen one.

The Autopsy Information Form should be filled out and sent along with the tissue. Both boxes (do not tie together) are to be sent overnight by Federal Express, Priority One Delivery. We can provide shipping containers and dry ice if needed, and will be happy to provide you with prepaid shipping labels to cover the cost of shipping the tissue.

Both packages should be addressed to:

Dennis Dickson, M.D.
Mayo Clinic Jacksonville
Birdsall 347
4500 San Pablo Road
Jacksonville, FL 32224
(904) 953-2439 or (904) 953-7137

Please send the tissue early in the week so as to avoid delivery during the weekend when no one will be here. Do not ship on Thursdays or Fridays.

Brain Support Network’s Packaging and Shipping Suggestions

Last Updated:  July 2022

With experience in monitoring the shipments of over 2,000 hemibrains, Brain Support Network has witnessed many tissue handling, packaging, and shipping errors. Here are our suggestions.

When to Ship

1.  For the integrity of the fixed tissue, it is highly preferred that the fixed hemisphere be fully fixed in formalin before sending. Ideally, the frozen hemisphere is sent at the same time as the fixed hemisphere but we recognize that many pathology service providers prefer to send the frozen hemisphere as soon as possible (keeping in mind Mayo Jax’s shipping requirements).

2. Brain tissue must be shipped early in the week because there’s no one at Mayo Jax to receive the shipment on the weekends. Never ship on Thursday or Friday, and do not ship when the next day is a holiday. Given recent problems with FedEx and containers with dry ice, we strongly advise against shipping on Wednesday. Best to ship on Monday or Tuesday, and track the shipments closely.

Around the year-end holidays, it is best to check with Mayo or Brain Support Network in advance of shipping. Mayo often requests that shipments be delayed during this period until early January.

3. Before shipping, please check the FedEx website for service alerts to be sure that there are no weather conditions in Florida, Tennessee (FedEx hub), or other locations that would delay shipping. FedEx has a link on its website to the National Weather Service’s weather map, showing severe weather. Note that hurricane season officially begins on June 1st every year.

Packaging the Containers

4.  The formalin fixed-specimen (left hemibrain) should be wrapped in formalin-soaked towels and double-bagged.  Take care not to over-fill the “inside” bag with formalin as leakage/spoilage was a recent problem that resulted in FedEx suspending transport of a shipment.

5.  Double bag the frozen tissue (right hemibrain) prior to shipping.  Never use RED biohazard bags as dry ice damages this type of plastic and this can destroy the tissue.

6.  Label the “outside” bag of the fixed and frozen tissue with the donor’s name and DOB, using a dark colored Sharpie marker. Write directly on the bag. Do NOT use stick-on labels or tape, as these fall off.

7.  Dry ice only should be used for the right hemibrain (frozen half). Under no circumstances should wet ice or refrigerant gel be used for shipping.

8.  The pathology information sheet must be included in each of two containers. You can also include the medical information sheet, if you have that available.

FedEx Issues

9.  Note that some pathology service providers have reported that FedEx has been unwilling to pick up or accept containers with dry ice. Please double-check with FedEx delivery staff who pick up from a usual location as to whether they have a problem with picking up dry ice. If you intend to drop off containers, note that regular FedEx locations will accept containers with dry ice. Many FedEx Office locations will not. If you have questions about this, please call 1-800-GoFedEx.

We’ve also had the situation where FedEx has accepted a container with dry ice, only to return it or delay delivery.  Once, in January 2016, a regular FedEx location accepted the package containing dry ice and then returned it to the pathology specialist’s address a few hours later, offering no explanation as to why it had been accepted earlier at the FedEx location only to be rejected later.  Twice in May 2016, FedEx delayed the delivery to Mayo of two containers where the label showed dry ice (“ICE”) was included.  Fortunately in both cases, tissue was shipped out on a Monday so we had a couple of days’ leeway to address the problem with FedEx.

Alerting Brain Support Network!

10. Immediately after shipping, please send a cell phone photo via text to Brain Support Network (cell phone 650-814-0848 – accepts texts) of the tracking numbers of the two containers.  Or, send an email.