Main autopsy findings in liver transplant patients.

The major autopsy findings from 22 patients (6 children, 16 adults) having undergone therapeutic orthotopic liver transplant are summarized. The mean age for children was 4.2 yr (range 4 mo to 9 yr) and 41 yr (range 20 to 57 yr) for adults. The mean posttransplant survival time in these patients was 16.7 d for children and 72.5 d for adults. The changes present in hepatic allograft included graft rejection (13), viral infections (11), massive necrosis due to hepatic arterial thrombosis (6), and recurrent hepatitis B (3). Infectious complications were present in 20 of 22 patients. The extrahepatic organs primarily involved by infection were lungs and brain. Bronchopneumonia and abscess formation were the most common lung findings, whereas cerebral edema and herniation, and infection occurred in the brain. Cardiac findings included acute myocardial infarction, mycotic mural thrombus and cytomegalovirus myocarditis. The gastrointestinal tract, adrenals, and kidneys were virtually spared. No significant changes were found in the pancreas and urogenital tract.