A novel treatment strategy for patients with many cysts in their liver led to a surprising result, reported in the online version of Gastroenterology by researchers from Radboud University Nijmegen Medical Centre, The Netherlands. A six month treatment with a synthetic gastrointestinal hormone lanreotide significantly decreased swollen cystic livers by approximately five percent, compared to a ‘wait and see’ policy.
At least five percent of the population has one or two cysts in the liver. Cysts are fluid-filled cavities. There are also many patients who have numerous cysts, which then is termed a polycystic liver. These cysts cause the liver to grow to four to six times its normal size. Until recently, surgery was the only possible treatment for these patients, but this approach leads to many complications, and the outcome is not always successful. Ultimately, these patients need a liver transplantation, but in view of the limited availability of organs, only few are actually transplanted.
Hepatologist Prof. Drenth, from Radboud University Nijmegen Medical Centre, commented: "In Nijmegen, we had experience with the administration of synthetic gastrointestinal hormones in two polycystic liver patients. This treatment resulted in significantly smaller liver cysts. This stimulated us to proceed to a randomized clinical trial in 54 polycystic liver patients from Nijmegen (The Netherlands) and Leuven (Belgium). Computer tomography indicated that the size of the average liver was 4.6 liters, at least three times the normal size. Twenty-seven patients received a monthly injection of lanreotide, and results were compared with 27 patients who received a placebo injection. After six months with lanreotide, the liver size was reduced by 2.9 percent, while that of the placebo group increased by 1.6 percent. Lanreotide worked best for patients with the largest livers."
This novel approach allows physicians to avoid the prospect of surgery. In the Netherlands there is an estimated group of 17,000 patients with polycystic livers, three quarters will face surgery because of their disease.
- van Keimpema L, Nevens F, Vanslembrouck R, van Oijen M.G., Hoffmann A.L., Dekker H.M., de Man R.A., Drenth J.P. Lanreotide Reduces the Volume of Polycystic Liver: A Randomized, Double-Blind, Placebo-Controlled Trial. Gastroenterology, 2009; DOI: 10.1053/j.gastro.2009.07.052
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