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      Blood taken immediately after fatal resuscitation attempts yields higher quality DNA for genetic studies as compared to autopsy samples

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          Abstract

          Background

          The out-of-hospital cardiac arrest (OHCA) in the young may be associated with a genetic predisposition which is relevant even for genetic counseling of relatives. The identification of genetic variants depends on the availability of intact genomic DNA. DNA from autopsy may be not available due to low autopsy frequencies or not suitable for high-throughput DNA sequencing (NGS). The emergency medical service (EMS) plays an important role to save biomaterial for subsequent molecular autopsy. It is not known whether the DNA integrity of samples collected by the EMS is better suited for NGS than autopsy specimens.

          Material and methods

          DNA integrity was analyzed by standardized protocols. Fourteen blood samples collected by the EMS and biomaterials from autopsy were compared. We collected 172 autopsy samples from different tissues and blood with postmortem intervals of 14–168 h. For comparison, DNA integrity derived from blood stored under experimental conditions was checked against autopsy blood after different time intervals.

          Results

          DNA integrity and extraction yield were higher in EMS blood compared to any autopsy tissue. DNA stability in autopsy specimens was highly variable and had unpredictable quality. In contrast, collecting blood samples by the EMS is feasible and delivered comparably the highest DNA integrity.

          Conclusions

          Isolation yield and DNA integrity from blood samples collected by the EMS is superior in comparison to autopsy specimens. DNA from blood samples collected by the EMS on scene is stable at room temperature or even for days at 4 °C. We conclude that the EMS personnel should always save a blood sample of young fatal OHCA cases died on scene to enable subsequent genetic analysis.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00414-023-02966-7.

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          Most cited references26

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          European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care

          The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation care guidelines for adults, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation, and organ donation.
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            European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe

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              A Prospective Study of Sudden Cardiac Death among Children and Young Adults

              Sudden cardiac death among children and young adults is a devastating event. We performed a prospective, population-based, clinical and genetic study of sudden cardiac death among children and young adults.
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                Author and article information

                Contributors
                hmilting@hdz-nrw.de
                Journal
                Int J Legal Med
                Int J Legal Med
                International Journal of Legal Medicine
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0937-9827
                1437-1596
                11 February 2023
                11 February 2023
                2023
                : 137
                : 5
                : 1569-1581
                Affiliations
                [1 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Erich and Hanna Klessmann-Institute for Cardiovascular Research and Development, Heart- and Diabetes Center NRW, , University Hospital of the Ruhr-University Bochum, ; Georgstr. 11, D-32545 Bad Oeynhausen, Germany
                [2 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Institute for Anesthesiology, Intensive Care- and Emergency Medicine, , Johannes Wesling Hospital Minden, MKK-Hospital, Campus OWL, Ruhr-University Bochum, ; Bochum, Germany
                [3 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Emergency Department, , Herford Hospital, Campus OWL, Ruhr-University Bochum, ; Bochum, Germany
                [4 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Institute for Pathology, , Herford Hospital, Campus OWL, Ruhr-University Bochum, ; Bochum, Germany
                [5 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Clinic for Thoracic and Cardiovascular Surgery, Heart- and Diabetes Center NRW, , D-32545 Bad Oeynhausen, University Hospital of the Ruhr-University Bochum, ; Bochum, Germany
                [6 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Center for Congenital Heart Diseases, Heart and Diabetes Center NRW, 32545 Bad Oeynhausen, , University Hospital of the Ruhr-University Bochum, ; Bochum, Germany
                [7 ]GRID grid.24381.3c, ISNI 0000 0000 9241 5705, Karolinska Institute, , University Hospital, Myocardial Genetic, ; 14157 Huddinge, Sweden
                [8 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Intensive Care and Emergency Medicine, Herford Hospital, Campus OWL, Ruhr-University Bochum, , University Clinic for Anesthesiology, ; Bochum, Germany
                [9 ]GRID grid.411544.1, ISNI 0000 0001 0196 8249, Institute for Pathology and Neuropathology, , University Hospital Tuebingen, ; D-72076 Tuebingen, Germany
                [10 ]Institute for Pathology, Johannes Wesling Hospital Minden, MKK-Hospital, D-32429 Minden, Campus OWL, Ruhr-University Bochum, Bochum, Germany
                [11 ]GRID grid.16149.3b, ISNI 0000 0004 0551 4246, Institute for Forensic Medicine, , University Hospital, Wilhelms-University Muenster, ; Muenster, Germany
                [12 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Institute for Anesthesiology, Intensive Care- and Emergency Medicine, , Luebbecke MKK-Hospital, Campus OWL, Ruhr-University Bochum, ; Bochum, Germany
                [13 ]GRID grid.7491.b, ISNI 0000 0001 0944 9128, Present address: Clinic for Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, , Bielefeld Hospital, University Hospital Eastern Westphalia–Lippe, Bielefeld University, ; Bielefeld, Germany
                Author information
                http://orcid.org/0000-0001-9722-0007
                Article
                2966
                10.1007/s00414-023-02966-7
                10421769
                36773088
                2deff6e0-ddf0-492e-9930-7ff02e3112f6
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 20 December 2022
                : 3 February 2023
                Funding
                Funded by: Heart and Diabetes Centre North Rhine-Westphalia (DKZ NRW) (1007)
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2023

                Law
                molecular autopsy,resuscitation,next-generation sequencing,cardiomyopathy,channelopathy,emergency medical service,dna stability

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