Mund Elias, Salem Johannes, Kreipe Hans H, Hussein Kais
Institute of Pathology, Hannover Medical School, Hannover, Germany.
Department of Urology, University Hospital Cologne, Cologne, Germany.
J Clin Pathol. 2022 Feb;75(2):112-116. doi: 10.1136/jclinpath-2020-207080. Epub 2020 Dec 28.
The number of clinical autopsies decreases while the rate of missed relevant diagnoses is known to be 2%-20%. In this study, we focused on postmortem examinations of patients after transplantation of solid organs.
A total of 122 cases were assessed for this study. Transplant organs included liver (LiTx; n=42/122, 34%), heart (n=8/122, 7%), lungs (n=32/122, 26%), kidney (KTx; n=38/122, 31%) and KTx+LiTx (n=2/122, 2%).
The most frequent autopsy-verified causes of death were cardiac or respiratory failure (together n=85/122, 70%). The frequency of malignant tumours that were identified at autopsy was 5% (n=6/122). In 3% (n=4/122) of cases, Goldman class I discrepancies between clinical diagnosis and autopsy findings were identified.
The rate of missed relevant diagnoses might be relatively low, but these cases nevertheless refute the contention that modern diagnostic techniques negate the need for autopsies in patients who died after transplantation.
