Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

11 June 2007

The Major Autopsy Findings in Adult Patients after Hematopoietic Stem Cell Transplantation

Said Khayyata, Ayman O. Soubani, Michelle Bonnett, Hind Nassar, Muneer H. Abidi, Mousa A. Al-Abbadi

Ann Transplant 2007; 12(2): 11-18 :: ID: 514513

Abstract

Background: Hematopoietic stem cell transplantation (HSCT) is a curative treatment option for hematological malignancies, but this treatment can be associated with a mortality risk.
Material/Methods: A ten-year retrospective review of all autopsies was performed where those who underwent HSCT were studied. The major autopsy findings and the cause of death were characterized and compared between those seen in allogeneic and those in autologous HSCT recipients. The study period preceded the use of prophylactic antifungal agents.
Results: A total of 66 autopsies were identified; 52 (79%) received allogeneic and 14 (21%) autologous transplantation. Death occurred at a median of 85 days post transplantation (range 2–1825 days); 36 (55%) died within the first 100 days post stem cells infusion. The major complications for HSCT patients were pulmonary, including diffuse alveolar damage (DAD), acute pneumonia and invasive pulmonary aspergillosis. The most common cause of death in the allogeneic HSCT group was DAD (13/52; 25%), followed by invasive pulmonary aspergillosis (10/52; 19%), acute pneumonia (10/52; 19%) and massive gastrointestinal bleeding (6/52; 12%); in the autologous group causes were disease relapse/progression of the underlying malignancy (4/14; 29%), acute pneumonia (3/14; 21%) and DAD (2/14; 14%).
Conclusions: We conclude that the spectrum of disease entities, commonly diagnosed at autopsy in HSCT recipients may provide insight to clinicians for anticipating complications and consequently help in the management of these high risk patients. The increased infectious complications observed in the allogeneic transplant cases may be explained by immunosuppression and that the study period preceded the use of prophylactic antifungal agents. However, relapse/progression of the disease is the predominant cause of mortality after autologous transplant.

Keywords: Bone Marrow, transplant

Add Comment 0 Comments

In Press

06 Feb 2024 : Case report  

Successful Sequential Liver and Isolated Intestine Transplantation for Mitochondrial Neurogastrointestinal ...

Ann Transplant In Press; DOI: 10.12659/AOT.941881  

12 Feb 2024 : Original article  

No Prognostic Impact of Graft-to-Recipient Weight Ratio on Hepatocellular Carcinoma Recurrence Following Li...

Ann Transplant In Press; DOI: 10.12659/AOT.942767  

21 Feb 2024 : Original article  

Use of LCP-Tacrolimus (LCPT) in Kidney Transplantation: A Delphi Consensus Survey of Expert Clinicians

Ann Transplant In Press; DOI: 10.12659/AOT.943498  

Most Viewed Current Articles

05 Apr 2022 : Original article  

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

22 Nov 2022 : Original article  

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358