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

Harrison, Philip M., Hughes, Robin D., Forbes, Alistair, 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
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 06 Aug 2014 10:46
Last Modified: 17 Mar 2020 20:01
URI: https://ueaeprints.uea.ac.uk/id/eprint/49519
DOI: 10.1016/0168-8278(90)90141-D

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