Case Studies

Rare but fatal if missed – intraoperative Takotsubo syndrome in adult liver transplantation: lessons for anaesthesia and intensive care clinicians

T. Chitagu, B. Bobat, A. Vachiat, J. Fabian, L. Brannigan
Southern African Journal of Anaesthesia and Analgesia | Vol 29, No 2 | a1146 | DOI: https://doi.org/10.36303/SAJAA.2956 | © 2023 T. Chitagu, B. Bobat, A. Vachiat, J. Fabian, L. Brannigan | This work is licensed under Other
Submitted: 19 November 2025 | Published: 30 April 2023

About the author(s)

T. Chitagu, Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
B. Bobat, Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
A. Vachiat, Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
J. Fabian, Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
L. Brannigan, Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa

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Abstract

Takotsubo syndrome is an important and often overlooked cause of reversible non-ischaemic perioperative cardiac decompensation. We report a case of intraoperative Takotsubo syndrome in an adult liver transplant recipient that occurred approximately 45 minutes after reperfusion of the implanted liver graft. In addition to multi-organ dysfunction requiring intensive life support, the recipient required venoarterial extracorporeal membrane oxygenation. Despite a prolonged hospital stay, three-month followup confirmed complete recovery of cardiac function. This case highlights the need for increased awareness of this condition and the need to facilitate appropriate care and referral pathways should perioperative Takotsubo syndrome occur.

Keywords

Takotsubo syndrome; liver transplant; perioperative cardiac decompensation; extracorporeal membrane oxygenation

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Southern African Journal of Anaesthesia and Analgesia  vol: 29  issue: 2  first page: 56  year: 2023  
doi: 10.36303/SAJAA.2979