Vasodilatory Shock After Heart Transplantation: the Enigma Continues

In this issue of the Journal, Batchelor et al.1 report on the prevalence and outcomes of vasoplegic syndrome following heart transplantation in a retrospective review of a 135-patient cohort at their institution between 2015 and 2020. They describe a 66% prevalence of vasoplegia, using a definition that included cardiac index and vasopressor doses to maintain a mean arterial pressure (MAP) > 65 mmHg. Advanced age, chronic kidney dysfunction, presence of continuous flow left ventricular assist device (cf-LVAD) pretransplant, and cardiopulmonary bypass time were identified as being predisposing factors to the development of vasoplegia post transplantation in their cohort.