Autopsy findings in cardiac transplant patients. A 10-year experience.
Findings from 44 autopsy examinations of cardiac transplant patients during a 10-year period were reviewed. The autopsy rate was 85%. One half of the autopsy patients underwent original transplantation for ischemic heart disease and 34% for cardiomyopathy. Survival after transplantation ranged from 0 (intraoperative) to 91 months. Rejection (including hyperacute rejection) was responsible for 41% of deaths, followed by infection (25%), and intraoperative deaths at first transplantation (9%). Most of the remaining complications were related to surgery or artificial heart support, accelerated allograft atherosclerosis, and lymphoma. Infections were not only responsible for a substantial percentage of deaths but were also a co-morbid finding in a number of patients who died primarily of other causes. Pulmonary infections represented the most common anatomic site. Twenty-five percent of the autopsy patients had gastrointestinal and/or pancreatic abnormalities, principally mucosal inflammation, erosions or hemorrhage, and pancreatitis. Review of premortem rejection history indicated that 64% of patients who died of or with rejection at autopsy had had an episode of rejection 3 weeks after transplantation and/or at least one episode of severe rejection.
Graham
A R
AR
Department of Pathology, University of Arizona Health Sciences Center, Tucson 85724.
D000293:Adolescent; D000328:Adult; D001161:Arteriosclerosis / Q000401:mortality; D001344:Autopsy; D002423:Cause of Death; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D007239:Infections / Q000401:mortality; D008297:Male; D009369:Neoplasms / Q000401:mortality; D014184:Transplantation, Homologous