Vasoplegic syndrome (VS) is a common occurrence during heart transplantation (HT). It currently lacks a uniform definition between transplant centers, and its pathophysiology and treatment remain enigmatic. This systematic review summarizes the available published clinical data regarding VS during HT. We searched databases for all published reports on VS during HT. Data collected included the incidence of VS in the HT population, patient and intraoperative characteristics, and postoperative outcomes. 22 publications were included in this review. The prevalence of VS during HT was 28.72% (95% CI: 27.37%, 30.10%). Factors associated with VS included male sex, higher body mass index, hypothyroidism, pre-HT left ventricular assist device or venoarterial extracorporeal membrane oxygenation (VA-ECMO), pre-HT calcium channel blocker or amiodarone usage, longer cardiopulmonary bypass time, and higher blood product transfusion requirement. Patients who developed VS were more likely to require postoperative VA-ECMO support, renal replacement therapy, reoperation for bleeding, longer mechanical ventilation, and a greater 30-day and 1-year mortality. The results of our systematic review are an initial step for providing clinicians with data that can help identify high-risk patients and avenues for potential risk mitigation. Establishing guidelines that officially define VS will aid in the precise diagnosis of these patients during HT and guide treatment. Future studies of treatment strategies for refractory VS are needed in this high-risk patient population.

中文翻译：

---

心脏移植期间的血管麻痹综合征：系统回顾和荟萃分析

血管麻痹综合征（VS）是心脏移植（HT）过程中常见的情况。目前移植中心之间缺乏统一的定义，其病理生理学和治疗仍然是个谜。本系统综述总结了已发表的有关 HT 期间 VS 的临床数据。我们在数据库中搜索了 HT 期间所有已发布的 VS 报告。收集的数据包括 HT 人群中 VS 的发生率、患者和术中特征以及术后结果。本次审查纳入了 22 篇出版物。HT 期间 VS 的患病率为 28.72%（95% CI：27.37%、30.10%）。与 VS 相关的因素包括男性、较高的体重指数、甲状腺功能减退、HT 前左心室辅助装置或静脉动脉体外膜氧合 (VA-ECMO)、HT 前钙通道阻滞剂或胺碘酮的使用、较长的心肺转流时间和较高的心率。血液制品输注要求。发生 VS 的患者更有可能需要术后 VA-ECMO 支持、肾脏替代治疗、出血再次手术、更长的机械通气时间以及更高的 30 天和 1 年死亡率。我们的系统评价结果是为临床医生提供数据的第一步，这些数据可以帮助识别高风险患者和潜在风险缓解途径。制定正式定义 VS 的指南将有助于在 HT 期间对这些患者进行精确诊断并指导治疗。未来需要对这一高危患者群体的难治性 VS 治疗策略进行研究。