Good logistics are key

Tissue acquisition from a patient is not to be taken lightly, which is good. I like a challenge.

I arrived in the Netherlands from my home country of Greece in 2008 to follow my dream of studying and working at a top university in molecular and cellular biology. For the first seven months, I dove into the language so that I could attend the University of Applied Sciences. Soon after graduation, I was offered a position at the UMC Utrecht as a research technician in the lab of Professors Onno Kranenburg and Inne Borel Rinkes. It soon became evident that there was a great need for a research coordinator and so, I quickly evolved into a study coordinator and have now created processes for the logistics of tissue acquisition for research purposes.

Setting up protocols makes logistics smoother

It all starts with the patient. Every week I attend multiple multidisciplinary meetings where patient cases are discussed. Depending on radiologic and pathologic results, biopsy results, the course of treatment is determined for each patient, and I assess whether a patient is eligible for a particular research study. Patients are scheduled to visit the outpatient clinic to talk with the appropriate doctors and nurse specialists in order to discuss the operation procedure and care. If a patient needs an operation, the nursing specialist meets with him/her to discuss the procedure. Then, I meet with the patient to explain the research study and ask for their consent to use a piece of their tissue.  

Sensitivity goes hand-in-hand with process

This is a fragile time for patients, who are at their most vulnerable and for me, this means actively implementing Good Clinical Practice protocols throughout the entire process, which, for instance, helps respect every patient’s wishes. I’ve learned to rely on my gut instinct when talking to patients. Every conversation is different and it’s important to be careful with what I can say and when, with identifying if a patient needs more time or more information, or if a patient simply needs to be heard.

It’s all in the details

When a patient does consent to donating tissue for research, I record and track their information, and when the operation date is available, I inform everyone involved in the process, so that they are aware when they can expect a specific tissue. On the day of the operation, I make sure that the appropriate paperwork is filled out and delivered to the Pathology department and that I have enough tubes with the correct culture medium for the sample. I then call the operating room to remind them to call me when it’s time to pick up the tissue and set an alarm to make sure that I’m on time.

Tissue acquisition from a patient is not to be taken lightly, which is good. I like a challenge

After I pick up the tissue I bring it to the pathologist and together we cut it open to examine it. Aside from the fascination of helping to dissect tumor biopsies, I’m there to make sure we get enough tissue for the particular research project. In general, a tissue sample of ~1 cm or less is too little for research. If there isn’t enough tissue, diagnostics is of course more important and I have to disappoint the researcher waiting for the sample. However, if there is enough tissue for research, I contact the researcher to tell him/her that the sample is ready.

It takes a village

I’m amazed at how many different teams of specialists, from surgeons to nurses to pathologists to radiologists to oncologists to researchers, are involved. And although everyone has their own way of working, together, we’ve designed and implemented a pipeline for tissue acquisition. I usually coordinate about 10 projects at a time, carry up to 3 telephones and depending on the project, can have up to 5-6 patients a day. This framework makes it all possible. Even if I sometimes don’t have time to help out with a new project, researchers can follow our protocols, do most of the tissue acquisition and processing themselves and not miss an opportunity.

The UPORT hub professionalizes tissue acquisition and processing

For the type of preclinical and translational research we excel in, tissue acquisition is a priority and ethically sensitive. In general, protocols are lacking and the establishment of the U-PORT hub gives us the opportunity to centralize and professionalize this. We’ll be able to expand our coordination capabilities and help more researchers and our infrastructure for the logistics of tissue acquisition and processing can be easily implemented into other projects. One recent example is the OPTIC clinical trial. I’ve been involved setting up processes for acquisition and processing of liver biopsies from patients with colorectal cancer. This trial is testing whether organoids grown from patient-derived liver metastases can predict drug treatment response. 

In addition to the logistics, the UPORT hub recognizes the importance of integrating education and training into the framework. The tissue samples we obtain are precious and not to be wasted. Through a variety of courses and activities, for example the Utrecht Summer School course, the UPORT hub introduces students and researchers to the potential of organoids to transform healthcare.

Anneta Brousali
Department of Surgery
UMC Utrecht