Adrenal insufficiency in patients with decompensated cirrhosis

Table 3 Characteristics and outcomes of the included studies in post transplanted patients

Ref.	Study design; studyperiod; country	No. of patients; type of liver disease	Adrenal failure	Definition of adrenal failure
Kharb et al[10]	Cross sectional; 2010-2011; India	10; OLT	Post LT: 4/10 (40%) RAI: Post LT: 7/10 (70%)	SST AI: Basal cortisol levels < 83 nmol/L or a peak cortisol response < 500 nmol/L RAI: Delta cortisol < 250 nmol/L
Marik et al[4]	Retrospective; 2002-2004; United States	119 post OLT recently and 51 remote OLT	Recent LT: 109/119 (92%) Remote LT: 31/51 (61%)	LDSST AI: (1) a random (stress) cortisol < 552 nmol/L in patients with hypoxemic respiratory failure, hypotension or requiring vasopressor agents and (2) a random level < 414 nmol/L or a 30-min post-low-dose cosyntropin stimulation test level of < 552 nmol/L in non-highly stressed patients
Patel et al[65]	Retrospective; NR; United Kingdom	90 patients; ICU post OLT; 45 patients received bolus dose of 1000 ng methylprednisolone intraoperative vs 45 patients not receiving	First group: significant reduced requirements for fluid administration (P = 0.02), vasopressors (P = 0.01), renal replacement therapy (P = 0.001), invasive ventilation (P = 0.01), and ICU stay (P = 0.02), compared to the second group

AI: Adrenal insufficiency; RAI: Relative adrenal insufficiency; SST: Short synacthen test; LDSST: Low dose short synacthen test; OLT: Orthotopic liver transplantation; LT: Liver transplantation; ICU: Intensive care unit; NR: Not reported.