脆弱性心脏病（Takotsubo syndrome，TTS）已经在实体器官移植受体中被报道。然而，有关肝移植后TTS的汇总数据仍然有限。本系统综述通过PubMed、Embase、Scopus和Google Scholar进行查找，截至2022年2月，纳入了关于肝移植相关TTS的案例报告/系列和原始研究，并进行案例报告的描述性分析和利用随机效应模型对患病率进行汇总分析。共纳入56个案例报告来自30篇文章（男性51.8％，平均年龄53岁；印度56％，美国27％，欧洲8.93％）和10项原始研究（美国88.65％，印度10.92％），揭示了与肝移植相关的TTS。TTS的汇总患病率为1.1％（95％ CI，0.6％-1.7％），与印度和美国研究具有可比性（P = .92）。肝移植的适应证包括终末期由于酒精相关肝硬化（25％），丙型肝炎病毒感染（17.9％），肝细胞癌（10.7％）以及非酒精性脂肪性肝炎（8.9％）；平均终末期肝病模型评分（Model for End-Stage Liver Disease score）为24.75。TTS通常表现为低血压（30％），呼吸困难（14％）和少尿，多在移植后发生（82％），而14％在术中发生。常见的心电图表现为ST段改变，心室性心动过速和房颤。常见的超声心动图发现显示46.5％的病例左心室心尖球部膨胀，41.9％的病例射血分数＜20％。常见的并发症包括心源性休克（32.1％），急性肾损伤（12.5％），心律失常，中风，心脏骤停和肝动脉血栓形成。机械循环支持在30.3％的病例中需要。15例患者报告有复发，30.4％的患者死亡。肝移植后TTS的患病率显著高于一般美国住院患者的TTS患病率，具有潜在的更糟糕的预后。需要建立前瞻性的登记簿，报告肝移植受体中的TTS。本文版权归2022 Elsevier Inc 所有，保留所有权利。

Takotsubo syndrome (TTS) has been reported in solid-organ transplant recipients. However, the pooled data regarding TTS after liver transplant remain limited.A systematic review was performed through February 2022 using PubMed, Embase, Scopus, and Google Scholar to review case reports/series and original studies on liver transplant-associated TTS. Descriptive analysis was performed for case reports and pooled analysis for the prevalence using random effects models.A total of 56 case reports were included from 30 articles (51.8 % male; mean age, 53 years; India 56%, US 27%, and Europe 8.93%) and 10 original studies (US 88.65%, India 10.92%) revealing liver transplant-associated TTS. The pooled prevalence of TTS was 1.1% (95% Cl, 0.6%-1.7%) of all liver transplants with comparable rates in studies from India and the US (P = .92). Indications for liver transplant included end-stage liver disease due to alcohol-related cirrhosis (25%), hepatitis C virus infection (17.9%), hepatocellular carcinoma (10.7%), and non-alcohol-related steatohepatitis (8.9%); the average Model for End-Stage Liver Disease score was 24.75. TTS commonly presented as hypotension (30%), dyspnea (14%), and oliguria, occurring mostly post-transplant (82%), whereas 14% were intraoperative. Common electrocardiogram findings were ST changes, ventricular tachycardia, and atrial fibrillation. Common echocardiogram findings showed left ventricular apical ballooning in 46.5% of cases and reduced ejection fraction < 20% in 41.9% of cases. Common complications were cardiogenic shock (32.1 %), acute kidney injury (12.5%), arrhythmia, stroke, cardiac arrest, and hepatic artery thrombosis. Mechanical circulatory support was required in 30.3%. Recurrence was reported in 15, and mortality in 30.4% of patients.Takotsubo syndrome prevalence after liver transplant is significantly higher than TTS prevalence in general US hospitalizations with potentially worse outcomes. Prospective registries reporting TTS in liver transplant recipients are warranted.Copyright © 2022 Elsevier Inc. All rights reserved.