Retention and Disposal of Organs or Tissues after a Post Mortem v7
Retention and Disposal of Organs or Tissues after a Post Mortem
Patient Information
Bereavement Service
Author ID: KR
Leaflet ref: BS 006
Version: 7
Leaflet title: Retention and Disposal of Organs or Tissues after a Post Mortem
Last review: July 2022
Expiry date: July 2024
Introduction
This leaflet is designed to tell you what happens to organs or tissues following a post mortem examination. It provides information on the options that are available to you regarding retention and disposal, when a post mortem has been conducted to determine the cause of death or to determine, clarify or confirm medical diagnosis that remain unknown or unclear.
What are retained organs/tissues?
- Retained organs/tissues are whole organs or pieces of tissue that have been removed at a post mortem examination carried out by a pathologist (a doctor who specialises in diagnosis of disease by studying tissues).
- They are usually kept for further examination to establish the cause of death, determine, clarify or confirm a diagnosis or used for research, teaching, education and training.
- They include organs or tissue blocks and slides (pieces of tissue taken from an organ). The main organs are the brain, heart, lungs, liver, kidneys and spleen. There are also smaller organs such as the pituitary gland and adrenal glands and also small sections can be removed from the skin.
- The tissue will be categorised as blocks, slides and wet tissue.
What are tissue blocks and slides?
- Tissue blocks are small samples removed from the organs; in adults this is approximately the size of a small postage stamp and a lot smaller in babies and children for obvious reasons. All tissue is made into blocks.
- The tissue blocks are specially treated with certain chemicals so that they become hard, this is so very thin sections can be cut from it.
- The thin sections cut from the block are placed on glass slides and stained with special dyes so that the cells can be examined under a microscope. Several slides may be cut from one block.
Some tests carried out after deaths require laboratory preparation of the organ or tissue so that a proper examination can be made. This particularly applies to the brain. If brain disease or injury is suspected, it can only be properly diagnosed if the brain is fixed with chemicals so that it can be examined by eye and under the microscope. The process of fixation takes about four weeks to complete, but sometimes can take longer. Thus, if the brain is being examined to establish the cause of death, in many cases burial or cremation of the body will already have happened. This raises the question of the subsequent disposal of the organ or tissue.
What are the options provided in relation to retention and disposal of organs/tissues?
There are several choices available for the retention and disposal of organs and tissues. You can choose what happens to the organ/tissue after any tests are completed; these will be discussed with you either by the coroners’ officer or a member of the hospital designated consent team, depending on which post mortem is being undertaken. It may be advisable to discuss the choices with family and friends before making a decision on what you would like to do.
The options for retention, return or respectful disposal of organs and tissues are as follows:
- To be reunited with the body before burial/cremation, understanding that this may delay the funeral.
- Return of the tissue(s) to the family or their appointed funeral director this option is usually after the funeral to ensure they are disposed of in a lawful way.
- The hospital carrying out the examination may dispose of the tissue(s) in a lawful and respectful way (by incineration).
- The hospital may retain the tissue(s) as part of the deceased medical records or use for future review, teaching, audit, research or genetic counselling purposes.
What is respectful disposal?
Respectful disposal may involve a ceremony that recognises the fact that human organs and tissue are being dealt with, the post mortem and bereavement services department has its own procedures in relation to this, so you may like to ask them for further details, they will also provide you with further information if you decide to undertake your own lawful disposal of tissue(s).
Is there anything else we need to know before making a decision?
- Cremation of tissue blocks, and slides may not always be possible as local crematoria may not always be willing to accept them for cremation. The coroner’s officer or hospital designated consent team will advise you what is possible in your area.
- When organs, tissue blocks, non-viable Foetal remains or pre full term babies are cremated there are usually no or very little ashes to return to family.
- Glass slides cannot be cremated.
- Burial may take place in a family burial plot or elsewhere, Funeral directors and burial authorities can offer advice on this.
- If you wish the burial to take place in an area that is not a church yard or cemetery a funeral director or your local council can advise you of this.
- Your funeral director may also be able to offer information on alternative options such as woodland burial.
- Once you have made a decision and informed the coroners’ officer or the hospital designated consent team, a time can be agreed for return, and respectful disposal can take place. A funeral director or family representative can act for your family at this stage if you do not want to be involved in the process providing, they have your written authority to do this.
What feelings might I experience?
No one can tell you exactly how you will feel. Some individuals will find that dealing with such sensitive issues reawakens feelings of grief and loss. There is no right way to grieve, and some people experience a whole range of different emotions at different times, it may also help to talk over the way you feel with someone you trust. You may find it hard to help each other, but there are experienced people who may be able to assist.
Where can I go for further information help and support?
Post mortem and bereavement services will endeavour to offer you any support and advice, as will your funeral director or coroners’ officer, so don’t be afraid to ask for their help.
Wigan Family Welfare
Offer a variety of free-of-charge services for those who need it. We provide a range of advocacy and counselling services.
St Catherine’s Vicarage, Catherine Terrace, Wigan WN1 3JW
Tel 01942 867888
www.wiganfamilywelfare.co.uk/
Child Death Helpline
Support offered from bereaved parent volunteers to anyone affected by the death of a child.
Great Ormond St Hospital, Great Ormond St, London WC1N 3JH
Tel 020 7813 8416
Free phone helpline 0800 282 986 Free mobile 0808 800 6019
Alder Hey Childrens NHS Foundation Trust, Eaton Road Liverpool L12 2AP
Tel 0151 252 5391
Child Bereavement UK
Supports families and educates professionals when a baby or child of any age dies or is dying, or when a child is facing bereavement.
Child Bereavement UK
Helpline 0800 0288 840
Cheshire branch 2nd Floor Ashley House Ashley Way West Widnes WA8 7RP
e-mail northsupport@childbereavementuk
Cumbria Branch Carlisle Youth Zone, Youth Zone, Victoria Place, Carlisle, Cumbria
e-mail same as Cheshire branch
Citizens Advice Bureau
Helps people resolve their legal, money and other problems by providing free information and advice.
Wigan Office Life Centre North, The WIEND Wigan WN1 1NH
Leigh Office Magnum House Lord Street Leigh WN7 1BY
0808 2787 801
Out of hours service – 7 days a week from 6pm – 9pm
Cruse Bereavement Care
Cruse is a voluntary organisation, which gives support and encouragement to bereaved people, it has no religious or political affiliations, and everyone is welcome.
Greater Manchester Branch
Tel 07377 710382
Lancashire Branch (Preston)
Tel 01772 433645
National help line 0808 808 1677
www.cursebereavementcare.org.uk
Department of Health
Implementing policies to improve health and health care
H.M. Coroner
Her Majesty's Coroner for the District of Manchester West is Mr Timothy Brennand Senior Coroner. This District covers Bolton, Salford, Wigan, and Leigh. The coroner records and investigates all sudden, unexpected, and violent deaths.
Coroner's Office, Greater Manchester West
Ground Floor, Paderborn House, Howell Croft North, Bolton, BL1 1JW
Tel. 01204 338799
www.bolton.gov.uk
Bereavement Liaison Specialist Nurse
Bereavement Midwife (Maternity Services)
Royal Albert Edward Infirmary, Wigan Lane, Wigan, WN1 2NN
Via Switchboard 01942 244000
Other organisations you may wish to contact where applicable:
Human Tissue Authority
HTA sets standards for licensed organisations that store and use human tissue for purposes such as research, patient treatment, post mortem examinations, teaching, and public exhibitions.
Human Tissue Authority
151 Buckingham Palace Rd, Victoria, London SW1 W 9SZ
Telephone: 020 7269 1900
www.hta.gov.uk
Whilst we are asking HTA staff to work remotely, please do not send enquiries in the post.
Inquest
This service provides advice and information for anyone facing an inquest.
3rd Floor 89-93 Fonthill Road London N4 3JH
Tel 020 7263 1111
Comments, complaints, and suggestions
We are determined to provide bereaved relatives with the best possible information on services that are available to them. We welcome all comments on the service we provide, whether good or bad, so that we can act on these comments to improve the service we provide. If you have any comments on the service you have experienced, you can make your comments to the person in charge of the department, or you can write or telephone:
Designated Individual for H.T.A
Mortuary Manager
Mortuary Department
Royal Albert Edward Infirmary
Wigan Lane
Wigan
WN1 2NN.
Tel. 01942 244000 Ext. 3565