Liver histology in ICU patients dying from sepsis: a clinico-pathological study.
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.
Koskinas
John
J
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
Gomatos
Ilias P
IP
Tiniakos
Dina G
DG
Memos
Nikolaos
N
Boutsikou
Maria
M
Garatzioti
Aspasia
A
Archimandritis
Athanasios
A
Betrosian
Alexander
A
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*