AGAINST polycystic liver growth
Polycystic liver disease (also called "cystic livers") is a genetic disease in which cysts grow in the liver unrestrictedly. Due to the cyst growth, the livers can become enlarged, sometimes up to 10-15 liters instead of the normal 2 liters. This large polycystic livers lead to several and sometimes severe complaints, such as pain, abdominal discomfort, loss of apetite, early satiety and diffuclty bending forward. Some patients have psychological complaints because of the disturbed body image, or have difficulty to participate in their jobs. In this thesis, we looked into medical treatment options for these large polycystic livers. In the first study, we showed that the only treatment currently available, somatostatin analogues, has gallstones as a side effect. These gallstones were assumed to be innocent, but our study showed that these gallstones can lead to severe complications, which clinicans should realize before these medications are prescibed. In the next studies, we showed that medication against estrogens could probably slow the liver growth. The majority of patients with the disease is female, and after menopause, sometimes symptoms decrease. Therefore, we looked into options to block estrogens, and designed a randomized controlled trial, for which we gained a Dutch ZonMW grant. The trial is running now, results are to follow. In the last study of the thesis we showed a fast and easy-to-use method to measure the liver volumes. Till now, liver volumes were measured manually, taking up to 2-3 hours per scan. With the new methods, we can measure the liver volume faster and easier, which is important to measure the progression of the disease, but also the effect of medications, for example in our medication trial.