title: Liver histology in ICU patients dying from sepsis: a clinico-pathological study.
abstract: OBJECTIVE
  To determine end-stage pathologic changes in the liver of septic patients dying in the intensive care unit.
  
  
  METHODS
  Needle liver biopsies obtained immediately after death from 15 consecutive patients with sepsis and no underlying liver disease were subjected to routine histological examination. Liver function tests and clinical monitoring measurements were also recorded.
  
  
  RESULTS
  Liver biochemistries were increased in the majority of patients before death. Histology of liver biopsy specimens showed portal inflammation in 73.3%, centrilobular necrosis in 80%, lobular inflammation in 66.7%, hepatocellular apoptosis in 66.6% and cholangitis/cholangiolitis in 20% of patients. Mixed hepatitic/cholestatic type of liver injury was observed in 6/15 (40%) patients and hepatitc in 9/15 (60%). Steatosis was observed in 11/15 (73.3%) patients affecting 5%-80% of liver parenchyma. Among the histological features, the presence of portal inflammation in liver biopsy was associated with increased hospitalization in the ICU prior death (P=0.026).
  
  
  CONCLUSIONS
  Features of hepatitis and steatosis are the main histological findings in the liver in the majority of patients dying from sepsis.
authors.affiliation: 2nd Department of Internal Medicine, Athens Medical School, and Intensive Care Unit, Hippocration General Hospital, 114 Vas. Sofias Ave, Athens 11527, Greece. labsures@med.uoa.gr
authors.forename: John
authors.initials: J
authors.lastname: Koskinas
authors.forename: Ilias P
authors.initials: IP
authors.lastname: Gomatos
authors.forename: Dina G
authors.initials: DG
authors.lastname: Tiniakos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Memos
authors.forename: Maria
authors.initials: M
authors.lastname: Boutsikou
authors.forename: Aspasia
authors.initials: A
authors.lastname: Garatzioti
authors.forename: Athanasios
authors.initials: A
authors.lastname: Archimandritis
authors.forename: Alexander
authors.initials: A
authors.lastname: Betrosian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D001707:Biopsy, Needle; D005234:Fatty Liver / Q000382:microbiology / Q000473:pathology; D005260:Female; D006505:Hepatitis / Q000382:microbiology / Q000473:pathology; D006801:Humans; D007297:Inpatients; D007362:Intensive Care Units; D008099:Liver / Q000382:microbiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000382:microbiology* / Q000473:pathology*