Failure of insulin and glucagon infusion to stimulate liver regeneration in fulminant hepatic failure

Harrison, Philip M., Hughes, Robin D., Forbes, Alistair ORCID: https://orcid.org/0000-0001-7416-9843, Portmann, Bernard, Alexander, Graeme J. M. and Williams, Roger (1990) Failure of insulin and glucagon infusion to stimulate liver regeneration in fulminant hepatic failure. Journal of Hepatology, 10 (3). pp. 332-336. ISSN 0168-8278

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Abstract

A randomised controlled trial of insulin and glucagon infusion was carried out in 18 patients in grade III or IV coma from fulminant hepatic failure due to viral or drug-induced hepatic necrosis to see whether mortality could be reduced by stimulating hepatic regeneration. Nine patients received a continuous infusion of insulin 3 U/h and glucagon 200 micrograms/h made up in 5% dextrose containing 1% human albumin solution (HAS) while controls received 5% dextrose and HAS alone. Baseline plasma insulin and glucagon levels were comparably raised in both groups and, on infusion, rose significantly higher in the insulin- and glucagon-treated patients compared to controls. Two control and one treated patient recovered. Median survival time from enrolment to death was similar for insulin- and glucagon-treated patients and controls--2 and 3 days, respectively. Insulin and glucagon therapy did not enhance hepatic synthetic function, as measured by a fall in prothrombin time or a rise in alpha-fetoprotein; nor did it stimulate hepatic regeneration, only one patient in each group showed histological evidence of hepatic regeneration at post-mortem.

Item Type: Article
Uncontrolled Keywords: adult,aged,female,glucagon,humans,infusions, intravenous,insulin,liver,liver diseases,liver regeneration,male,middle aged,randomized controlled trials as topic,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 06 Aug 2014 10:46
Last Modified: 03 Oct 2022 07:00
URI: https://ueaeprints.uea.ac.uk/id/eprint/49519
DOI: 10.1016/0168-8278(90)90141-D

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