A review of room temperature storage of biospecimen tissue and nucleic acids for anatomic pathology laboratories and biorepositories

• Room temperature storage can lower spatial, fiscal, and environmental costs.
• Current room temperature technologies can store purified nucleic acids for years.
• Stabilization solutions permit room temperature whole tissue storage for 1 week.
• Alcohol-based formalin-free fixatives yield good histology and nucleic acids.
• Lyophilization shows promise for long-term whole tissue stabilization.

Frozen biospecimens are crucial for translational research and contain well‐preserved nucleic acids and protein. However, the risks of freezer failure as well as space, cost, and environmental concerns of frozen biospecimens are substantial. Objective: The purpose of the study was to review the current status of room temperature biospecimen storage. Methods: We searched Pubmed and vendor websites to identify relevant information. Results: Formalin-fixed paraffin embedded (FFPE) tissues have great value but their use is limited by cross-linking and fragmentation of nucleic acids, as well as loss of enzymatic activity. Stabilization solutions can now robustly preserve fresh tissue for up to 7 days at room temperature. For longer term storage, commercial vendors of chemical matrices claim real time stability of nucleic acids of over 2 years and their accelerated aging studies to date suggest stability for 12 years for RNA and 60 years for DNA. However, anatomic pathology biorepositories store mostly frozen tissue rather than nucleic acids. Small quantities of tissue can be directly placed on some chemical matrices to stabilize DNA, however RNA and proteins are not preserved. Current lyophilization approaches can preserve histomorphology, DNA, RNA, and proteins though RNA shows moderate degradation after 1-2 years. Formalin‐free fixatives show improved but varying abilities to preserve nucleic acids and face validation as well as cost barriers in replacing FFPE specimens. The paraffin embedding process can degrade RNA. Conclusion: Development of robust long-term room temperature biospecimen tissue storage technology can potentially reduce costs for the biomedical community in the face of growing targeted therapy needs and decreasing budgets.