Technical insights and implications of thoracolumbar spine and neural tissue harvesting in recently deceased organ donors: a direct anterior approach integrated into multi-organ procurement protocols.

PURPOSE: To present a novel anterior surgical technique for harvesting thoracolumbar spinal tissue from cadaveric organ donors. The approach aims to ensure biological viability of harvested spinal tissue, while maintaining full compatibility with routine multi-organ procurement protocols. By addressing the limited availability of anterior harvesting methods, this technique aims to expand opportunities for high-quality experimental and translational spine research.

METHODS: A direct anterior retroperitoneal approach was employed to harvest thoracolumbar spinal columns en bloc, including the spinal cord, dorsal root ganglia (DRGs), vertebral bodies, intervertebral discs, facet joints, and posterior elements. All extractions were performed within 1–2 h following aortic cross-clamping to minimize ischemic time. The surgical procedure included targeted osteotomies to preserve structural continuity, with intraoperative radiographic imaging performed to ensure alignment and suitability for subsequent research use. Tissue samples underwent same-day processing for experimental use, including viability assays to assess the cellular health of key structures.

RESULTS: This harvesting protocol was applied in over 340 cadaveric donors as part of a high-volume organ donation program. The mean harvesting time was approximately 30 min. In all cases, structural continuity of the anterior spinal column was preserved, with radiographic imaging confirming appropriate alignment and completeness of the harvested specimens. Cell viability assessments demonstrated excellent preservation of biologically active components, including viable disc and joint tissues, neural structures, and resident cell populations. The harvested tissues have been successfully used in a variety of research projects.

CONCLUSION: This anterior spinal harvesting technique is a safe, efficient, and highly reproducible method that can be seamlessly integrated into standard multi-organ procurement workflows. It enables the acquisition of sterile, anatomically intact, and biologically viable spinal tissues from cadaveric organ donors without compromising donor reconstruction or surgical logistics. This approach substantially enhances the availability and quality of human spinal specimens for research and may serve as a useful model for tissue recovery in the field of spine science.