Review Article

Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation

Table 1

(a) Literature review of Takotsubo Syndrome following abdominal transplant

Authors# of patientsSexAgeDiseaseOrgan transplantedManagementOutcome

Anders et al. [14]OneMale66Laennec’s cirrhosisLiverIABP on POD 2–23Full recovery of cardiac function 40 days postop
Bedanova et al. [15]OneFemale51Autoimmune hepatitis and cirrhosisLiverIABP on POD 2–9Full recovery of cardiac function 30 days postop
Chrapko et al. [16]OneFemale46Polycystic kidney diseaseKidneyMedical management. Diagnosed by TEE and 123I-mIBG myocardial uptakeFull recovery of cardiac function by 180 days postop
Eagle et al. [17]OneMale64Laennec’s cirrhosisLiverRCA vasospasm found on cardiac catheterization, apical ballooning persisted. Transvenous pacemaker placed. Delayed biliary reconstruction to the following daySmall subdural hematoma treated medically. Discharged to rehabilitation facility on POD 16
Gołębiewska et al. [18]OneFemale68GlomerulonephritisKidneyMedical management. Possible association with Calcineurin Inhibitor Toxicity.Full recovery of cardiac function in 22 days post op
Harika et al. [8]OneMale52Hemochromatosis and Laennec’s cirrhosisLiverMedical Management with vasopressorsFull recovery of cardiac function in 18 days postop
Lee et al. [19]OneFemale65Nonalcoholic steatohepatitis with hepatocellular carcinomaLiverMedical managementFull recovery of cardiac function 6 weeks postop
Phillips et al. [20]OneFemale60Primary biliary cirrhosis, pulmonary embolus, renal failure, clostridium difficile colitisLiverMedical management with beta blockade and aspirinFull recovery of cardiac function 16 days postop
Saner et al. [21] 1/2Male60Hepatitis B cirrhosisLiverMedical Management with beta blockade.Recovery, doing well 4 years after transplant
2/2Female62Hepatitis C cirrhosisLiverMedical management with vasopressors, hemodialysisDeath within 24 hours after transplant
Tachotti Pires et al. [22]1/2Female33Primary sclerosing cholangitisLiverMedical management initially with vasopressors, then ACEI and beta blockadeRecovery of EF on POD 10 though diagnosed with apical hypertrophic cardiomyopathy maintained on beta blockers
2/2Male36Budd-Chiari syndromeLiverMedical management with vasopressorsRecovery of cardiac function by POD 7 but found to have bacterial endocarditis, and expired 27 days postop
Tiwari and D’Attellis [23]OneFemale45Nonalcoholic steatohepatitisLiverMedical management with vasopressors. Delayed biliary reconstruction to the following day. IABP POD 2–5Resolution in 12 days after transplant, though patient expired from hemorrhage
Vailas et al. [24]OneMale51Trauma-inducing ESRDKidneyMedical management with vasopressors.Full recovery of cardiac function 4 days postop, but attempt at stenting RAS led to loss of allograft on POD 56
Vachiat et al. [25]OneMale56Laennec’s and HCV cirrhosisLiverLeft ventricular assist deviceFull recovery of cardiac function by POD 25

IABP: intra-aortic balloon pump; POD: postoperative day; TTE: transthoracic echocardiogram; RCA: right coronary artery; ACEI: ace inhibitor; EF: ejection fraction; RAS: renal artery stenosis.
(b) Case demographics, management, and outcomes summary

CaseSexAgeDiseaseOrgan transplantedManagementOutcome

Case 1Female45IgA nephropathyKidneyMedical managementFull cardiac recovery POD 6
Case 2Male54Laennec’s cirrhosisLiverIABPNear-total recovery of heart function at 3 mo
Case 3Male34Laennec’s cirrhosisLiverIABP, ICDPartial recovery (EF 35%) at 5 mo
Case 4Male57Laennec’s and Hepatitis C cirrhosisLiverIABPDeath, POD2
Case Female46Laennec’s cirrhosisLiverIABP, ICD (preexisting)Partial recovery (EF 35%) at 1 mo
Case 6Male57Laennec’s and Hepatitis C cirrhosisLiverTandemHeartFull cardiac recovery 3 mo
Case 7Male66Laennec’s and Hepatitis C cirrhosisLiverTandemHeartFull cardiac recovery 1 mo

IABP: intra-aortic balloon pump; POD: postoperative day; ICD: implantable cardioverter defibrillator; EF: ejection fraction.