Abstract
levels 30–60 minutes after ACTH stimulation; delta cortisol (Dc = Pc −Bc]. AI was defined as at least two of the following: Bc < 148nmol/L, Pc < 550nmol/L, Dc < 250nmol/L. All patients had Methylprednisolone intraand post-operatively. Parameters of graft and renal function were recorded 48 hours post-LT. Results: 18 patients (22.5%) had AI. Patients with AI had higher MELD score (19 vs. 15; p = 0.003), higher pre-LT INR, bilirubin and potassium, and lower sodium and haemoglobin levels. 48 hours post-LT patients with AI had higher creatinine (152 vs. 91umol/L; p = 0.038) compared to those with normal adrenal function. There was no difference in mechanical ventilation, vasopressor support, renal replacement therapy, length of ICU and hospital stay between the two groups. Parameters that correlated with 48-hour creatinine were age, Bc, Pc and pre-LT creatinine. In multivariate analysis only Pc and pre-LT creatinine were significant predictors of 48-hour creatinine. Conclusions: Pre-LT AI was associated with immediate post-LT renal dysfunction in our study. The full extent of AI implications may have been masked by the intaand post-operative use of steroids. These results should be confirmed in further studies.
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