Autopsy-determined causes of death following organ transplantation in 25 patients aged 20 years or younger.
OBJECTIVE
This study aims to examine the autopsy-determined principal and proximate causes of death in 25 patients aged 20 years or younger who died during the 10-year period from 1990 to 1999 after receiving an organ transplant at the University of Minnesota/Fairview-University Medical Center.


METHODS
The autopsy records of this institution were examined for organ transplant recipients who were aged 20 years or younger at the time of their death. In each case, after review of the clinical and pathological data, the principle cause of death (PCOD), as well as the proximate cause of death (PXCOD) were noted.


RESULTS
A total of 25 recipient patients were identified (five heart, five lung, five kidney and 10 liver transplants). Seven patients died 30 days or less post-operatively and 18 died thereafter. The following categories of PCOD were encountered: operative/technical complications 28%, most (6/7) being associated with liver transplantation. Infection (24%) and chronic rejection (12%) were other important PCOD. Respiratory complications accounted for 47% of the PCOD. The following categories of PXCOD were noted: technical problems 16%, pulmonary pathology 24%, miscellaneous 32%, acute rejection 4% and nil 20%.


CONCLUSIONS
This study revealed that technical problems in liver transplants were an important PCOD; respiratory complications and chronic rejection were additional major causes of mortality in this young age group of transplant recipients. Pulmonary pathology and technical problems were the commonest specific groups contributing to the PXCOD.
Rose
Alan G
AG
Department of Laboratory Medicine and Pathology, University of Minneapolis, Minnesota, USA.
D000367:Age Factors; D001344:Autopsy; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000401:mortality; D006801:Humans; D007239:Infections / Q000401:mortality; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D016377:Organ Transplantation / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality; D013997:Time Factors