Takotsubo Syndrome in Orthotopic Liver Transplant: A Systematic Review and Pooled Analysis of Published Studies and Case Reports.

Autor: Bachayev M; Department of Medicine, International University of the Health Sciences, St. Kitts, Nevis., Brereton B; Department of Medicine, Jersey General Hospital, Saint Helier, Jersey., Mondal A; Department of Internal Medicine, Nazareth Hospital, Philadelphia, Pennsylvania., Alli-Ramsaroop BA; Department of Pediatric Surgery, Georgetown Public Hospital Corporation, Georgetown, Guyana., Dhakal R; Department of Medicine, Nepal Medical College, Kathmandu, Nepal., Leon MCB; Department of Medicine, Universidad de San Martin de Porres, Lima, Peru., Quinones CM; Department of Medicine, Universidad de San Martin de Porres, Lima, Peru., Abdelal MEO; Department of Medicine, International University of the Health Sciences, St. Kitts, Nevis., Jain A; Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania., Dhaduk K; Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, Pennsylvania. Electronic address: kartikdhaduk@gmail.com., Desai R; Independent Researcher, Atlanta, Georgia.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2024 Nov; Vol. 56 (9), pp. 2075-2083. Date of Electronic Publication: 2023 Feb 27.
DOI: 10.1016/j.transproceed.2022.11.005
Abstrakt: Background: Takotsubo syndrome (TTS) has been reported in solid-organ transplant recipients. However, the pooled data regarding TTS after liver transplant remain limited.
Methods: A systematic review was performed through February 2022 using PubMed, Embase, Scopus, and Google Scholar to review case reports/series and original studies on liver transplant-associated TTS. Descriptive analysis was performed for case reports and pooled analysis for the prevalence using random effects models.
Results: A total of 56 case reports were included from 30 articles (51.8 % male; mean age, 53 years; India 56%, US 27%, and Europe 8.93%) and 10 original studies (US 88.65%, India 10.92%) revealing liver transplant-associated TTS. The pooled prevalence of TTS was 1.1% (95% Cl, 0.6%-1.7%) of all liver transplants with comparable rates in studies from India and the US (P = .92). Indications for liver transplant included end-stage liver disease due to alcohol-related cirrhosis (25%), hepatitis C virus infection (17.9%), hepatocellular carcinoma (10.7%), and non-alcohol-related steatohepatitis (8.9%); the average Model for End-Stage Liver Disease score was 24.75. TTS commonly presented as hypotension (30%), dyspnea (14%), and oliguria, occurring mostly post-transplant (82%), whereas 14% were intraoperative. Common electrocardiogram findings were ST changes, ventricular tachycardia, and atrial fibrillation. Common echocardiogram findings showed left ventricular apical ballooning in 46.5% of cases and reduced ejection fraction < 20% in 41.9% of cases. Common complications were cardiogenic shock (32.1 %), acute kidney injury (12.5%), arrhythmia, stroke, cardiac arrest, and hepatic artery thrombosis. Mechanical circulatory support was required in 30.3%. Recurrence was reported in 15, and mortality in 30.4% of patients.
Conclusions: Takotsubo syndrome prevalence after liver transplant is significantly higher than TTS prevalence in general US hospitalizations with potentially worse outcomes. Prospective registries reporting TTS in liver transplant recipients are warranted.
Competing Interests: DISCLOSURE The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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