Pathological findings of liver allografts evaluated at autopsy.

OBJECTIVES: We review the pathological findings as determined by autopsy of the liver allografts.

MATERIALS AND METHODS: We retrospectively analyzed 408 patients who had a liver transplant between January 1990 and December 2012. Thirteen of the 408 patients underwent postmortem examination. Clinicopathologic findings including the age at death, causes of death, and main pathological findings were evaluated.

RESULTS: The study group of 13 patients who underwent a liver transplant had a mean age of 29 years at the time of death. Mean survival was 6 ± 1 months (range, 10-72 mo). Ten of 13 patients (76.9%) died 90 days after the liver transplant. The remaining 3 patients died, 1 case in 1 year, in 2 cases after 1 year. Causes of the deaths were infection (9 cases), respiratory distress (1 cases), multiorgan failure (1 cases), primary graft failure (1 cases), and massive intra-abdominal bleeding (1 cases). The causes of the infection were bacterial infection in 6 cases (67%) and invasive fungal infection in other 3 cases (33%). The main pathological finding was hepatic infarction in 9 cases (69%). Bridging fibrosis (3 cases) and hematoma (1 case) were obtained in the remaining cases.

CONCLUSIONS: Our results emphasize that infections are the main cause of death and hepatic infarction is the main histopathologic findings among these 13 patients within the first year of transplant. We consider postmortem examination to have important role in determining the primary graft failure and other causes that increased mortality in liver transplant recipients. An autopsy can provide understanding of the main causes and cause of death.