Abstract
Post-mortem human brain banks are a key resource for researching brain diseases. The New South Wales Brain Tissue Resource Centre (BTRC) is a brain bank that uniquely focuses on the recruitment, preparation, and dissemination of tissue from patients with alcohol use disorder and controls. Our controls are prospectively followed through their lifetime via a self-reported questionnaire and yearly updates, and these standardised data allow future matching to disease cases based on individual study needs. Brain banks are expensive to run, and their sustainability is an ever-present topic of concern worldwide. In this review, we explore how the BTRC is adapting to a changing research environment by updates to our banking pipeline, before considering different models whereby brain banks can add greater value to research of the brain and other organs. First, brain tissue research is undergoing a major transformation with the rapid uptake of single-cell and spatial platforms. Brain banks must ensure that their protocols are optimised and updated to match the requirements of these new platforms. The BTRC has moved to rapid fixation of tissue and is trialling freezing protocols that minimise cytoarchitectural damage. Second, post-mortem brain banks are inherently retrospective and cannot ordinarily contribute to research during a donor's lifetime. However, brain banks can also expand their portfolio to include clinical samples and derivatives such as cell lines, and this may promote greater donor interest in subsequent brain donation. Third, brain banks have traditionally run as stand-alone operations given their unique reliance on invasive autopsies and whole organ banking. However, with the increased interest in brain-body interactions, multi-organ tissue banks holding both clinical and post-mortem samples could enable the discovery of general disease mechanisms. Finally, the single-cell and spatial platforms are producing data at a phenomenal rate. Rather than seeing data derived from tissue disseminated to disparate repositories, banks could curate the data in-house and enable dry-lab research alongside their traditional focus on tissue studies. Overall, post-mortem brain banking is an important part of the brain research environment, but the banking pipeline must be designed to maximise benefits for donors and future generations.