[Augmented hepatic regeneration of living donor liver graft by intraportal insulin administration].
OBJECTIVE
To evaluate the effect of postoperative intraportally administration of insulin on hepatic regeneration in adult patients underwent living donor right lobe liver transplantation (LDLT).


METHODS
From July 2005 to September 2007, 15 right lobe LDLT adult recipients voluntarily receiving posttransplant intraportal insulin administration, without postoperative vascular and bile duct complications, without immune rejection, with more than 1 month survival and complete clinical data were enrolled in this study as intraportal insulin-therapy group (Group I). Another consecutive 15 right lobe LDLT adult recipients meeting the upwards referred criteria were enrolled in as non-insulin-therapy control group (Group NI). Recipients in Group I were treated postoperatively with intraportal insulin infusion, as follows: a 18-gauge catheter was inserted into right gastro-omental vein during surgery, regular insulin was administered just after the operation at the rate of 2 units/hour for 7 days. Liver function and serum insulin level were measured at before-operative day 1, postoperative day (POD) 7 and 30. Graft volume (GV) were measured during operation, and at POD 7 and 30.


RESULTS
The rate defined as ratio of POD 7 GV/operation GV in Group I was higher than that of Group NI [(186.1 +/- 35.4)% vs. (160.6 +/- 22.1)%, P < 0.05]. The rate defined as ratio of POD 7 GRWR/operation GRWR was also higher in Group I than Group NI [(179.0 +/- 35.8) % vs. (156.6 +/- 18.5%, P < 0.05], whereas significant differences were not appeared between two groups in terms of regeneration rates at POD 30. Serum levels of total bilirubin, aspartate aminotransferase and alanine aminotransferase in Group I were lower than that in Group NI at POD 7 (P < 0.05). Significant differences were not presented between two groups in terms of post-transplant serum insulin levels and total insulin dosage by subcutaneous administration and venous injection (P > 0.05).


CONCLUSIONS
These results suggest that intraportal insulin administration could augment liver graft regeneration during the first postoperative week.
Xu
Ming-Qing
MQ
Division of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041, China.
Yan
Lü-Nan
LN
Li
Bo
B
Zeng
Yong
Y
Wen
Tian-Fu
TF
Zhao
Ji-Chun
JC
Wang
Wen-Tao
WT
Yang
Jia-Yin
JY
ma
Yu-Kui
YK
Cheng
Zhe-Yu
ZY
Zhang
Zhong-Wei
ZW
D000328:Adult; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008115:Liver Regeneration / Q000187:drug effects*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011184:Postoperative Period; D012189:Retrospective Studies; D055815:Young Adult
D007328:Insulin