To investigate the clinical characteristics, diagnosis and treatment experience of Takotsubo cardiomyopathy (TC) after liver transplantation.

Literature of liver-transplantation-associated TC, published before April 30, 2021, were retrieved in PubMed, Medline, Embase, Wanfang Data, CNKI and Chongqing VIP databases. The search terms in Chinese were "((stress cardiomyopathy) or (Takotsubo cardiomyopathy) or (left ventricular apical balloon syndrome) or (Takotsubo syndrome)) and (liver transplantation)", and the English ones were "((Takotsubo cardiomyopathy) or (Takotsubo syndrome)) and ((liver transplantation) or (liver transplant))". The baseline data, clinical characteristics, diagnosis and treatment were analyzed.

22 articles consisting of 59 patients were included. Among them, 30 patients were male and 29 female, aged (56±10) years on average. The manifestations of TC were mainly chest pain, dyspnea, oliguria and cardiac arrest, etc. The median onset time of TC in 31 cases was postoperative 1(0-201) d. Cardiac function examination revealed that left ventricular ejection fraction was significantly decreased and myocardial enzyme spectrum indexes were increased. ECG abnormality were ST segment elevation and/or T wave inversion, and no obstructive coronary artery disease was observed. Emergency treatments consisted of cardiopulmonary resuscitation, use of hemodynamic drugs and/or intra-aortic balloon counterpulsation. Heart function was recovered in 29 cases, and the time of heart function recovery was 18(2-180) d. 6 cases died with a mortality of 17%(6/35).

TC is a rare disease associated with liver transplantation. Prompt resuscitation, rational use of hemodynamic drugs and/or intra-aortic balloon counterpulsation are potential approaches to improve clinical prognosis.