Operationalizing rapid research autopsy: lessons learned from the Last Gift program

PURPOSE OF REVIEW: Rapid research autopsy programs provide access to tissues that are difficult or impossible to sample during life, but their scientific value depends on practical implementation systems that can be activated unpredictably while preserving specimen identity, quality, and participant dignity. RECENT FINDINGS: Experience from the Last Gift rapid research autopsy program, drawing on 46 rapid autopsies over 9 years, illustrates practical strategies for premortem readiness, participant-specific tissue allocation, team activation, procurement under time constraints, preservation, documentation, biobanking, shipping, and postautopsy quality improvement. SUMMARY: Rather than presenting a site-specific protocol, this practical implementation review identifies reproducible infrastructure and decision points that help teams adapt rapid research autopsy programs to their own communities, scientific priorities, institutional resources, and collaborating laboratory needs.