I am looking for help in establishing a reasonable turn around time for
rapid processing of kidney biopsy specimens on transplant patients. Our
clinicians  want "four hours from collection to microscopic slides
available for diagnosis." We have been trying to meet these expectations
but the quality is suffering, not to mention the level of stress in the
department. The major problem is the reduced processing times are impacting
the morphology. Is there anyone out providing this type of Rush service? If
so, would you be willing to share your procedure? Our current protocol is
to fix in 10% formalin, process on a short run, embed and to cut 20 serial
slides at 2 microns staining with H&E, PAS and trichrome. The PAS needs to
be available for interpretation with the H&E. The trichrome can be sent
later. I almost forget, this includes transport time >from the University
campus to our consolidated lab (different campus, across the river) for
processing and the slides returned for interpretation. We usually received
the specimens at 12:45 and have the slides available for return transport
at 3:45. Which reduces actual technical time to 3 hours.

One of our clinicians wants us to replace the formalin fixation with
Zenkers (as they did in the good old days) to improve the quality, any
comments on that suggestion?  Thanks in advance for your help.