Mayo Clinic Rochester Protocol and Shipping Instructions

Brain Support Network helps families make arrangements to donate a loved one’s brain for research and so the neurological diagnosis can be confirmed.

Occasionally, the Mayo Clinic in Rochester, Minnesota (“Mayo Rochester”) is the brain bank where brains are donated.  In general, Brain Support Network only assists Mayo Rochester with brain donation for multiple system atrophy (MSA) cases.

Below, we will keep the latest research protocol for Mayo Rochester along with their shipping instructions.  Note that the whole brain is donated.  The family may also decide to donate the spinal cord.

In short, the Mayo Rochester protocol requires that the whole brain (and possibly the spinal cord) be removed within 24 hours of death.  The clinic asks if a two small samples can be taken, which are frozen.  The remaining brain (and spinal cord) are fully immersed in formalin buffered to 10%, and fixed for 10-14 days.  Mayo Rochester provides containers and dry ice, and pays for shipping.

Plus, we list below Brain Support Network’s shipping suggestions.  These have been developed over many years of stories using FedEx as the shipping agent.

Robin
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Mayo Clinic Rochester – Research Protocol
Last Updated:  April 2017 (about frozen samples)

We greatly appreciate your help in obtaining brain tissue for our study on central degenerative autonomic disorders.  Enclosed please find a copy of a personal directive for autopsy that your patient will sign to advise his/her family that an autopsy be done at the time of death (original sent to patient).

Our group is engaged in the study of patients with multiple system atrophy (Shy-Drager syndrome), Parkinson’s disease, or dementia with Lewy bodies.  We are particularly interested in pathological alterations in the brainstem of these patients and have a NIH-funded grant to study immunocytochemically-defined cell groups in the medulla, hypothalamus and, spinal cord when available.

We would appreciate it if you can assist us in the study of this patient’s brain by informing us at the time of this patient’s death.  Given the lability of immunocytochemical techniques to postmortem delay and fixation we require that the tissue be harvested within 24 hours of death.  In order to facilitate handling of the brain, we request the following:

It is highly desirable to examine the entire brain and spinal cord, if possible.

Please remove 1cm3 of right frontal lobe, and 1cm3 of cerebellum in the area of the vermis, freeze and ship separately on dry ice. We can provide coolers if needed. 

Carotid artery in the area of the bifurcation, base of heart with attached great vessels, abdominal aorta with mesenteric ganglia/vessels, distal esophagus/stomach junction, and distal colon (3 inches) is also highly desirable. 

The brain (minus frozen samples) should be immersed in 10% formalin for 7-10 days.

We understand that this protocol is different from others you may have encountered; this is due to the nature of our research.  We greatly appreciate your assistance in this informative study.  If there are any questions or concerns, please contact one of us directly please call Ann first: Ms. Ann Schmeichel, my research technician (daytime phone: 507-284-8597, evening phone: 507-584-0201, cell phone 507-219-1652, fax: 507-284-3133).  Please follow this protocol as closely as possible.  Thank you for your assistance.

Sincerely,
Phillip A. Low, M.D.

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Mayo Clinic Rochester – Shipping Instructions
Last Updated:  2017

1. The brain (minus frozen samples) should be immersed in 10% formalin for 7-10 days, double bagged, and boxed.

2.  Please ship by Federal Express to

Ann Schmeichel
Neurophysiology Laboratory
Mayo Clinic
805 Guggenheim Building
200 First Street SW
Rochester, MN 55905

Please contact Ann either by phone or email at [email protected] and she will make sure that you have labels for shipping.

3.  We will cover all expenses involved in autopsy, handling, and mailing of the material.

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Brain Support Network’s Notes about Mayo Rochester’s Protocol
Last Updated:  April 2017

1.  We believe Mayo Rochester’s instructions about the frozen samples are rather skimpy but hopefully pathology service providers can figure things out!  If not, contact Ann Schmeichel at Mayo Rochester.  She will provide shipping containers and dry ice for the frozen samples.

2.  Many pathology service providers prefer to send the frozen samples as soon as possible. Given our experience with FedEx, we suggest shipping out the frozen samples on a Monday or Tuesday only.  Under no circumstances should wet ice be used.

3.  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 this.  Regular FedEx locations will accept containers with dry ice; however, many FedEx Office locations will not.

4.  The formalin fixed whole brain should be double-bagged for shipping.  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.  Any good quality Styrofoam shipping container can be used.  Mayo Rochester will provide a container.

5.  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’s webpage is:

www.fedex.com/us/servicealerts/index.html 

FedEx has a link on its website to the National Weather Service’s weather map, showing severe weather.

6.  Before shipping, consult with Ann Schmeichel at Mayo Rochester to be sure she is in the office or someone is accepting packages.

7.  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.

8.  Immediately after shipping, please send a cell phone photo via text to Robin Riddle (cell phone 650-814-0848 – accepts texts) of the tracking numbers of the frozen containers and the fixed container.  Or, send an email containing the tracking numbers to Brain Support Network.  This way Brain Support Network can monitor the shipments.  It is best that the pathology service provider monitor the shipments as well, in case any issues arise during transit.

9.  Around the year-end holidays, Mayo will often request that shipment be delayed.  It is best around the year-end to check with Mayo or Brain Support Network in advance of shipping.