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Time-dependent postmortem redistribution of morphine and its metabolites in blood and alternative matrices—application of CT-guided biopsy sampling

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Abstract

Interpretation of postmortem morphine concentrations in forensic toxicology provides several pitfalls such as missing information on tolerance, analyte stability, or postmortem redistribution (PMR). Recently, it had been shown that computed tomography (CT)-guided collection of biopsies using a robotic arm (virtobot) provides a valuable strategy for systematic studies on time-dependent PMR. Using this technique, time-dependent PMR of morphine and its metabolites was investigated in 12 cases. At admission to the institute (t1), femoral and heart blood (right ventricle) as well as biopsies from the right lung, the right kidney, liver, spleen, and muscle tissue were collected. At autopsy approximately 24 h later (t2), samples from the same body regions were collected again. Additionally, gastric contents, urine, brain tissue, and heart blood from the left ventricle was collected. Morphine, normorphine, hydromorphone, morphine-3-glucuronide, morphine-6-glucuronide, and morphine-sulfate were quantified with LC-MS/MS. In femoral blood, significant increase of morphine concentrations was observed, although ultimately not relevant for forensic interpretation. In the alternative matrices, increases as well as decreases were observed without a clear trend. The morphine metabolites did not exhibit relevant concentration changes. Investigation of underlying redistribution mechanisms indicated that concentration change (i.e., increase) of morphine in femoral blood rather resulted from diffusion processes than from release of morphine from its conjugates. Concentration changes in heart blood might have been caused by redistribution from lung tissue or gastric content. This study also proved that CT-guided collection of biopsies using a virtobot arm is an invaluable tool for future studies on PMR redistribution of other substance groups.

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Acknowledgments

This work was supported by the Swiss National Science Foundation (grant no. 310030_165875). The authors would like to thank the group from the Department of Forensic Medicine and Imaging, ZIFM, for their assistance and Prof. B. Seifert and the scientists from the Department of Forensic Pharmacology and Toxicology, ZIFM, for helpful discussions.

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Authors and Affiliations

  1. Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland

    Sandra N. Staeheli, Thomas Kraemer & Andrea E. Steuer

  2. Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland

    Dominic Gascho & Lars C. Ebert

Authors
  1. Sandra N. Staeheli
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  2. Dominic Gascho
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  3. Lars C. Ebert
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  4. Thomas Kraemer
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  5. Andrea E. Steuer
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Correspondence to Andrea E. Steuer.

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Declaration of no objection for ethical approval was obtained by the cantonal ethics committee of Zurich, Switzerland (number 42.2005).

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The authors declare that they have no conflict of interest.

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Staeheli, S.N., Gascho, D., Ebert, L.C. et al. Time-dependent postmortem redistribution of morphine and its metabolites in blood and alternative matrices—application of CT-guided biopsy sampling. Int J Legal Med 131, 379–389 (2017). https://doi.org/10.1007/s00414-016-1485-2

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  • DOI: https://doi.org/10.1007/s00414-016-1485-2

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