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Clinically latent and autopsy-verified inflammatory disorders and malignant tumours in transplant patients
  1. Elias Mund1,
  2. Johannes Salem2,
  3. Hans H Kreipe1,
  4. Kais Hussein1
  1. 1Institute of Pathology, Hannover Medical School, Hannover, Germany
  2. 2Department of Urology, University Hospital Cologne, Cologne, Germany
  1. Correspondence to Professor Kais Hussein, Institute of Pathology, Hannover Medical School, Hannover, Niedersachsen, Germany; Hussein.Kais{at}


Aims 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.

Methods 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%).

Results 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.

Conclusions 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.

  • autopsy
  • transplantation
  • quality control
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  • Handling editor Dhirendra Govender.

  • Contributors Data collection: EM, JS, KH. Analysis of data: EM, JS, KH. Interpretation of data and manuscript preparation: EM, JS, HHK, KH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The retrospective study was approved by the local ethics committee (#2893-2015).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplemental information. Deidentified participant data.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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