Introduction: An autopsy is a specialized surgical procedure to determine the cause and the manner of the death. Autopsies are also used in clinical medicine for the evaluation of any disease or injury that may be present. The number of autopsies performed for medical purposes has been decreasing since 1950s. The reduction in autopsies is negatively affecting to detection of early causes which can lead to disease. The survival of patients undergoing liver transplantation has increased in the last years because of improvements including selection of candidates, surgical procedures and postoperative management of patients. Analyses of the causes of death after liver transplantation are important to to improve liver transplant recipient survival. The aim of this study was to review the pathological findings as determined by autopsy of the liver allografts.

Materials and Methods: We analysed 408 patients who had liver transplantation between January 1990 and December 2012 retrospectively. Thirteen of 408 patient was underwent postmortem examination. Clinicopathologic findings including age at the death , causes of deaths and main pathological findings were evaluated.

Results: The study group of 13 patients whom underwent liver transplantation had a mean age of 29 years at the time of death. The mean survival time was 260.69 ±586.78 days for all these patients. Ten of 13 (76.9%) were died 90 days after liver transplantation. Remaining 2 patients were died after the first year of the transplantation.The causes of the deaths were due to infection (6 cases), respiratuar distress (2 cases), multiorgan failure (1 cases), primary graft failure (1 cases), massive intraabdominal bleeding (1 cases) and hepatic encephalopathy (1 cases). The causes of the infection were bacterial sepsis in 3 cases and invasive fungal infection in other 3 cases. The main pathological findings was hepatic infarction in 9 cases. Bridging fibrosis (3 cases) and hematoma (1 cases) were obtained in remaining cases. Our results emphasize that infections are the main cause of the death and hepatic infarction is the main histopathologic findings among these 13 patients within the first year of transplantation.

Conclusions: We consider that post-mortem examination have important role in order to determine the primary graft failure and the other causes that increased mortality in liver transplantation patients such as infections.Autopsies can provide understanding the main causes and the manner of the death to expanding lifespan in the future.