Clinicopathological Correlations in Postasphyxial Organ Damage: A Donor Organ Perspective

Abstract

Objectives. 1) To assess pathology in the heart, kidneys, lungs, liver, and intestine in babies dying of postasphyxial hypoxic ischemic encephalopathy (HIE), and their suitability for organ transplantation. 2) To analyze the correlation between in vivo clinical markers of collateral organ damage and autopsy findings. Study Design. Retrospective cohort study of 58 infants who died of postasphyxial HIE and had autopsies during 1985 to 1994. Collateral organ damage was evaluated clinically and pathologically, and the results compared. Results. Severe pathological changes were observed in 6% to 62% of the five organs studied; 59% of the four major organs had either minor or no pathology. The sensitivity of the clinical predictors ranged from 69% to 100%, and specificity from 50% to 97%. Conclusions. The organs of newborns dying of severe HIE may be suitable for use as donor organs; predictions of their suitability were most accurate for liver, kidney, and lungs, and least accurate for the heart.