S2547 Takotsubo Cardiomyopathy Following Liver Transplant: A National Cohort Characterization

Introduction: Liver transplantation is a complex surgery that involves significant peri- and post-operative physiological and emotional stress. The incidence and characteristics of Takotsubo cardiomyopathy (TCM), also known as stress-induced cardiomyopathy, in this setting is poorly understood. Given the hemodynamic fluctuations and catecholamine surges associated with an orthotopic liver transplantation (OLT), we aim to characterize clinical features of patients who suffered TCM after an OLT. Methods: A single arm descriptive study was conducted using the TriNetX database, identifying patients who underwent an OLT and diagnosed with TCM based on International Classification of Diseases, Tenth Revision (ICD-10) codes. We established baseline demographics, comorbidities, and liver disease data to establish a descriptive characterization of this population. Results: Following OLT, 168 patients were diagnosed with TCM. The average age at index was 55.9 years old, and 50.0% of these patients were woman. 70.0% of patients were White, 8.3% were Asian, and 6.0% were Black. The most common etiology of advanced liver disease was alcohol mediated (58.9%), followed by metabolic dysfunction-associated steatohepatitis (36.3%) and chronic viral hepatitis (26.8%), with 14.9% having hepatitis C and 11.9% having hepatitis B. 46.4% were diagnosed with hepatorenal syndrome. With regards to cardiac comorbidities, the mean EF was preserved at 58.1% ± 9.8%, and 26.8% of patients were diagnosed with atrial fibrillation. Of note, 17.3% of patients were diagnosed with bacteremia. Conclusion: Takotsubo cardiomyopathy is a significant yet underrecognized complication following liver transplantation. In this single arm, multi-center descriptive study, TCM occurred across a diverse patient population with advanced liver disease. Further studies are needed to identify at-risk individuals.