-We have lots of different types of wet specimens, many of them are very old,
but some of them are actually quite new. This specimen is one of our newest wet specimens,
I think it's the newest wet specimen. It's a heart that came from a heart transplant patient,
who is still alive and doing great. His name is Rob, we're just going to use his first name.
And what's great about this is we've actually been documenting the whole process ever since the heart
came to us. So, we were able to get the heart, we did an unboxing video, we got to see what that
looked like, and then we have the heart now in the specimen jar. But a lot of really interesting
things were going on between those two things. And this is Lowell and he is our Collections Manager
and Registrar, but he also does conservation of our wet specimens as well. And what we decided to
do was kind of walk you through what we had to do to transform this heart, since it came out of the patient,
until it came into this jar. Like what what happened? What kind of things did we do?
-So you saw the heart when it came to us from North Carolina,
and they kind of vacuum packed it. I thought they were going to give us a kind of wet container,
but they did a dry packing where they took the heart, and they packed it in a kind of
wet formalin-soaked towels. -In a little square.
-In a square, put it in basically a Tupperware,
but the big thing is that they vacuum sealed that sucker so tight that when we opened it up,
the heart had kind of assumed the shape of the rectangular Tupperware.
So it didn't look anything like a heart, it kind of looked like very sad lunch meat.
-Very appetizing. -Yes, sorry, I apologize, but it honestly looked like
those weird loaves in the deli counter that nobody ever actually orders...
It had to go back to its original shape and it didn't just spring back, what did you have to do
to kind of get it back to its original shape? -Well, first as a caveat, we'll say it's not
totally back to its original shape. If you look closely, it's a little flat,
but at least it expanded this way. And the secret to that was mostly just getting it out of the
packaging and allowing it to rehydrate. And it basically approached this size merely in the
formalin-soaking stage. And then once we did the formalin into water it got as big as it's gonna get.
-Did you have to do any extra formalin, like injections or anything like that?
-Yeah, once we took it out of the box, I had a tray and I just moved it over, and took a syringe,
filled the syringe with formalin, and injected a few spots here and there, where the tissue's the
thickest just to make sure it's fixed all the way through. And I injected it, left it in formalin
for 24 hours in sealed Tupperware. After 24 hours in the formalin, I then moved it into water
with an open top so the formalin could off-gas. And it sat in the water bath for 24 hours as well.
And then after that it started an ethanol process where I first placed it in 25% ethanol, then 50%, then 70%.
-It's important to step it up into the concentrations because what would happen if
you just went from like 0% to 60%? -If you were to just go straight into 70% ethanol,
you'd have risk of precipitates forming that don't happen if you do it slowly. So even though it's more expensive,
it's worth it usually to do a step so you don't get unexpected precipitate. And it also just gave
it more time to rehydrate, and we left the top off for a long time to allow for as much off-gassing
as possible during the ethanol stages. And I did three more changes of ethanol before we sealed it.
And then once it seemed stable enough, I prepared this jar and put a plate of glass in there to give
the appearance of floating. And then sealed the lid with silicon and should be stable for a
while now. We may reopen it at some point because there's some fogging on the glass.
-Yeah, I see something. Honestly it's really not that bad, but I like that you pointed out the
difference, so there are different ways of mounting. A lot of our specimens actually have holes,
holes were put in them and they were literally sewn to these kind of pipette scaffoldings, and
that's fine, that's one way to do it, but then you're artificially putting a hole
into a specimen, and then it's more susceptible to any vibrations and things like that, and of ripping
and then falling because, just to be very clear, specimens like this don't float. If you put
them in a jar they will sink down to the bottom unless you have some sort of structural support.
By doing the glass, you don't have to put any holes in there. It's much, as I would guess, it's
a minimally invasive mounting procedure. And it really looks great! And to go back to the
having to inject it, I think that's important to note because a heart is a muscle.
It's got very dense tissue, so a soak sometimes wouldn't necessarily permeate all of it.
But to add to that, which is interesting, is this is a heart of from an individual
that had acromegaly. So acromegaly being a hormonal disorder, one of the side effects
is that your heart can become enlarged, but not in a good way. In a kind of hyper muscular way that
actually, that's the reason why Rob needed a heart transplant. So his heart tissue is actually even
more dense and more muscular, so it's very important that we had to do those injections
to make sure that was properly preserved or else, I'm guessing, it probably could potentially start
to decay from the inside out. -Yep, that's why we always make sure
it's thoroughly injected. Yes, contrary to "The Grinch," if your heart expands to 10x its size,
you have a problem. -Not a good, not a good thing.
But you know, another thing of note, you might notice it's cut here on the top
because they actually leave the top portion of the heart in the chest cavity, and then
put the new heart in along with it. So it's not like a full one-to-one exchange,
they still leave a little part of it in there. And that was really interesting in our discussions
with the surgeons. They they did warn me, they're like, "By the way, it's not going to be a full heart."
But I still think it looks very heart-like. And we also had to have a discussion
with the pathologist because any organ, any foreign body, pretty much anything that comes out of you
at the hospital has to go through pathology. And they'll do lots of different things,
anything from completely slicing up the body part and obliterating it to doing some
minimally invasive things. So before we got the heart, we were in talks, lots of emails
and letters going back and forth with Rob's medical team, and we had to make sure to have
a very important conversation with pathologists to find out how much tissue they needed to take,
where could they take it from that would be the least destructive. And because normally,
when the heart is good, it would probably just go to the incinerator. They keep it for a little bit of
a time and then, like a lot of medical waste, goes to the incinerator. But for us, they were very nice
and they just did minimal incisions and minimal biopsies. So you can see here, this is actually
the back of the heart. So you have the anterior is the front and posterior is the back.
So this is the posterior section of the heart-- I believe, I'm more of a heart tissue expert--but
pretty sure that's what it is. And you can see they made an incision here. And then multiple little
incisions and cuts here, where they took the tissue. And they did it for a variety of
reasons, and again to kind of get an idea of how damaged the heart was due to the acromegaly.
So this is an amazing specimen, not only because of of how it looks and the condition
that it's in, but the story behind it. We are still in contact with Rob, and he had his heart
transplant in the summer of last year. We received the heart back I want to say around July?
And it's been here, undergoing its preparation. And I'm just so excited to be able to
showcase the heart, and tell the whole story behind it because Rob has been very gracious to
allow us to talk about his medical journey and to share information like that with us.
And so that's why it's so important now to have this living donor program here. And we hope to
collect more specimens like this with obviously the full consent and participation of the donor.
That just adds such an amazing extra layer to the story. -A full narrative.
-A real benefit. -It is! I think from an educational standpoint,
but also, my hope is that when you look at this specimen,
it's not going to be just a heart, it's going to be Rob's heart and
Rob's story. So it's the beginning of a different way to start looking at these specimens beyond
just, "This is the heart of a person with acromegaly." Like this is Rob's story.
-A real flesh-and-blood person. -Yeah, and we're just so happy that he
allowed us to have access not only to his heart, but to his story. And hopefully we'll keep you
posted on his progress. And maybe we can even do an interview with him over Zoom or Skype, or whatever
those things are, and continue this this journey and keep you more informed about it.