Urinary Tract, Sexual Organs, and Pregnancy Conditions

Diseases and Abnormalities at or Before Birth

All Conditions

Digestive System Diseases

Neoplasms

Symptoms and General Pathology

Rare Diseases

Polycystic Kidney Diseases

Polycystic Kidney, Autosomal Dominant

Liver Diseases

Cysts

Kidney Diseases

Gastrointestinal Diseases

Kidney Diseases, Cystic

Urologic Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Male Urogenital Diseases

Congenital Abnormalities

Abnormalities, Multiple

Ciliopathies

Genetic Diseases, Inborn

Pathological Conditions, Anatomical

Autosomal Dominant Multiple Pterygium Syndrome

Menopause

Polycystic Liver Disease

Antineoplastic Agents

Reproductive Control Agents

All Drugs and Chemicals

Hematinics

Leuprolide

Liver Extracts

Antineoplastic Agents, Hormonal

36 months of treatment with study medication

First 18 months standard care, hereafter 18 months treatment with study medication

Treatment consist of leuprorelin 3.75 mg once monthly for the first 3 months followed by 3-monthly injections of 11.25 mg. The direct start group will use leuprorelin for 36 months. The delayed start group will use standard of care in the first 18 months.

Leuprorelin

Ron T Gansevoort

Renée Duijzer

Renée Duijzer, msc

Sophie Aapkes

Multicenter trial on the effect of the GnRH analogue leuprorelin on the growth of total liver volume in pre-menopausal women with very severe polycystic liver disease who, despite available therapy, experience growth and are heading for liver transplantation.

Randomized, controlled trial in which patients are randomized between either 1. Direct start with treatment or 2. Delayed start with treatment which will start after 18 months of standard care with the study medication

Patient blinding is not possible, since leuprorelin will induce menopause related complaints.

Primary outcome is not reported to investigators until the study has finished. Outcome assessors are blinded for study subject and treatment allocation.

Female hormones, especially estrogen, seem to play a pivotal role in liver growth. More than 90% of patients is female and exogenous estrogen administration enhances liver growth and liver growth declines after menopause.

A GnRH Agonist IN Pre-menopausal Women STudy to Treat Severe Polycystic Liver Disease

Liver volumes (in % per year) measured in the MRI at screening, 6 months, 18 months, 24 months and 36 months

PLD related complaints assessed by the Polycystic liver disease-Questionnaire at baseline, 6 months, 18 months, 24 months and 36 months

Menopause related complaints by using the validated MENQOL questionnaire at baseline, 6 months, 18 months, 24 months and 36 months

Quality of life and as subset mental health will be measured by the validated RAND SF-36 questionnaires at baseline, 6 months, 18 months, 24 months and 36 months

Quality of life and as subset physical health will be measured by the validated RAND SF-36 questionnaires at baseline, 6 months, 18 months, 24 months and 36 months

Kidney volumes (in % per year) measured in the MRI at screening, 6 months, 18 months, 24 months and 36 months

Anti Muller Hormone will be assessed at screening. Other Extensive laboratory includes estradiol, progesterone, AMH, FSH, LH levels at baseline, 6 months after start therapy and after 18 and 36 months.

Bone density measured by a DEXA scan at screening, 18 months and 36 months.

eGFR measurements and 24h urine analyisis (in ADPKD patients only) at baseline, 6 months, 18 months, 24 months and 36 months time

Manual blood pressure measurements in millimetres of mercury (measure 3 times with 2 minutes in between) at screening, baseline, 3 months, 6 months, 12 months, 18months, 21 months, 24 months, 30 months and 36 months .

Heart rate in beats per minute (measure 3 times with 2 minutes in between) measured at screening, baseline, 3 months, 6 months, 12 months, 18months, 21 months, 24 months, 30 months and 36 months .

Body weight in kilograms measured at screening, baseline, 3 months, 6 months, 12 months, 18months, 21 months, 24 months, 30 months and 36 months .

Upper-arm-circumference in centimeters of the non-dominant arm measured at screening, baseline, 3 months, 6 months, 12 months, 18months, 21 months, 24 months, 30 months and 36 months.

Abdominal circumference in centimeters (measured at the level of the umbilicus) measured at screening, baseline, 3 months, 6 months, 12 months, 18months, 21 months, 24 months, 30 months and 36 months .

At screening, length will be collected to calculate Body Mass Index.

At screening length in centimeters will be collected.

During each physical or telephone contact, the adverse effects are queried and registered in accordance with national protocol

Symptoms of depression measured by the validated BD-II questionnaires at baseline, 6 months, 18 months, 24 months and 36 months

Radboud University Medical Center

University Medical Center Groningen

Behaviors and Mental Disorders

Quality of Life

will receive PLD-Q, EORTC QLQ-30 symptoms subscale, EQ5D-VAS score and SF36

PLD-Q

Marie C Hogan, MD, PhD

Marie C Hogan

Tom Gevers

Patrick Kamath

Jeff Sloan

Joost Drenth

This Pilot study will enable development \& assessment of a Polycystic Liver Disease-specific patient reported outcomes questionnaire (PLD-Q). Polycystic liver disease (PLD) is characterized by the formation of numerous cysts in the liver, and can lead to severe symptomatic hepatomegaly. It is common in patients with autosomal dominant polycystic liver disease (ADPLD) and autosomal dominant polycystic kidney disease (ADPKD).

As liver function is preserved, quality of life is the main outcome in PLD. Patient reported outcomes are increasingly utilized to assess treatment efficacy \& can include any endpoint derived from patient reports \& are usually assessed by questionnaire. Several existing generic questionnaires assess gastrointestinal symptoms, but include irrelevant items for polycystic liver disease (PLD) \& do not examine relevant extra-abdominal symptoms. Also, a questionnaire that assesses the full range of PLD related problems is more likely to be responsive to changes after treatment initiation. Therefore, a tool that accurately detects changes in PLD symptoms is required.

The development and first steps of validation of this questionnaire are already completed in Netherlands. We will further develop this questionnaire for English speaking patients and validate it in Mayo Clinic cohorts.

The study contains three phases. Phase 1: pilot testing of the directly translated questionnaire (from dutch into english) in a small group of polycystic liver disease (PLD) patients. We will include both symptomatic \& asymptomatic patients (i.e. from mild to severe PLD). Phase 2: further refinement of the questionnaire using the results of the pilot test and input of Mayo patient and clinician focus groups. Phase 3: Further validation in a large cohort of 200 PLD patients with (1) comparison with 200 controls without PLD, (2) cross-sectional correlation with total liver (TLV) \& kidney volumes (TKV), (3) comparing ADPKD patients with \& without PLD (5) against other validated questionnaires (e.g. SF36) \& (5) development of a custom "Worry Questionnaire" examining disease-related worries \& concerns. Finally, longitudinal analyses will be performed to assess PLD-Q sensitivity to change in symptoms. Statistical \& psychometric analyses will be provided by Mayo Clinic quality of life Research group, \& developed in accordance with Food and Drug Administration (FDA) guidance on patient-reported outcome measures in consultation with their Study Endpoints \& Labeling Development Division.

Development and Assessment of The Polycystic Liver Disease Questionnaire (PLD-Q).

Development and Assessment of the Psychometric Properties of a Polycystic Liver Disease-specific Patient Reported Outcomes Questionnaire (PLD-Q).

measured in patients with autosomal dominant polycystic kidney disease (ADPKD)

Mayo Clinic

Musculoskeletal Diseases

Nervous System Diseases

Arthrogryposis

Joint Diseases

Muscular Diseases

Musculoskeletal Abnormalities

Arthrogryposis Multiplex Congenita

Anti-Infective Agents

Central Nervous System Depressants

Pharmaceutical Solutions

Ethanol

Minocycline

Sclerosing Solutions

Aspiration sclerotherapy is a percutaneous procedure that evacuates fluid from the liver cyst and subsequently exposes cyst lining to a sclerosing agent (e.g. ethanol, minocycline) for a limited period of time.

Laparoscopic fenestration exposes the liver through laparoscopic surgery. During this procedure the cyst is punctured and drained followed by resection of the extra-hepatic cyst wall

aspiration sclerotherapy versus laparoscopic fenestration

Joost P.H. Drenth

Thijs Barten

Radboudumc University M Center

Patients with large hepatic cysts (\> 5cm) may develop symptoms. These can be captured with the polycystic liver disease questionnaire (PLD-Q). Treatment of large hepatic cysts consists of aspiration sclerotherapy or laparoscopic fenestration.

The safety and efficacy of both procedures has been explored in two recent systematic reviews yet no evident conclusion regarding superiority of either procedure could be drawn.

The main objective of the ATLAS trial is to compare laparoscopic fenestration and aspiration sclerotherapy in patients with large symptomatic hepatic cysts on patient-reported outcomes.

Rationale: Patients with large hepatic cysts(\>5cm) may develop symptoms due to distention of Glisson's capsule and/or compression on other abdominal organs. Frequently reported symptoms include abdominal pain, early satiety, nausea, and dyspnea. These symptoms can be captured in the disease-specific Polycystic Liver Disease Questionnaire (PLD-Q), a validated instrument. The treatment of symptomatic liver cysts is aimed to improve symptoms and quality of life by reducing cyst volume. There are two procedures available to treat symptomatic liver cysts: percutaneous aspiration sclerotherapy and laparoscopic fenestration.

In aspiration sclerotherapy, fluid is evacuated from the liver cyst and subsequently the cyst lining is exposed to a sclerosing agent for a limited period of time. Sclerotherapy causes temporary recurrence of cyst fluid after drainage, but subsequently results in a steady decrease of cyst volume in the majority of patients.

In laparoscopic fenestration the liver is exposed through laparoscopic surgery. In this procedure the cyst is punctured and drained followed by resection of extra-hepatic cyst wall.

The safety and efficacy of aspiration sclerotherapy and laparoscopic fenestration have been explored in two recent systematic reviews. No evident conclusion could be drawn because of the retrospective study design in the vast majority of the studies and the heterogeneity among these. A randomized controlled trial is warranted to identify the possible differences in safety and efficacy in aspiration sclerotherapy and laparoscopic fenestration.

Hypothesis: The investigators expect patients treated with laparoscopic fenestration to have better clinical outcome; i.e. a lower PLD-Q score, compared to aspiration sclerotherapy, when measured 4 weeks after the procedure. The investigators expect this difference to become smaller over time (after 6 and 12 months), with loss of statistical significance.

Objective: The main objective is to compare laparoscopic fenestration and aspiration sclerotherapy in patients with large symptomatic hepatic cysts on patient-reported outcomes. This information can be used to assess cost-effectiveness in both treatments.

Study design: A prospective, randomized clinical superiority trial in which patients will be randomized 1:1 to one of the treatment arms. Patients will be followed for 1 year.

Study population: All patients ≥18 years who are diagnosed with a dominant, simple hepatic cyst (\>5 cm in diameter), that are symptomatic (PLD-Q score ≥20) and have an indication for treatment (both aspiration sclerotherapy and laparoscopic fenestration) are suitable for inclusion in this study. Only patients that are eligible for both treatments can be included in this study. In particular, patients with multiple cysts (\>20 cysts of \>1.5 cm) will be excluded as surgery leads to more complications in these patients.

Intervention: Patients will be randomly allocated to either aspiration sclerotherapy or laparoscopic fenestration. Both procedures are performed according to the standard Radboudumc protocols. Aspiration sclerotherapy consists of ultrasound-guided, percutaneous drainage of the cyst with subsequent sclerosation with ethanol. Laparoscopic fenestration consists of standard abdominal laparoscopy in which the large cyst(s) are drained and deroofed.

Main study parameters: The main study parameter is the PLD-Q score at 4 weeks after treatment. Secondary parameters are among others: PLD-Q score at baseline, 6 months and 12 months; liver volume (CT) at baseline and 4 weeks; cyst volume (ultrasound) at baseline, 4 weeks, 6 months and 12 months; complications according to Clavien-Dindo; admission duration, recurrence and re-intervention rates.

Assessment of Treatment With Laparoscopic Fenestration or Aspiration Sclerotherapy for Large Symptomatic Hepatic Cysts

Assessment of Treatment With Laparoscopic Fenestration or Aspiration Sclerotherapy for Large Symptomatic Hepatic Cysts (ATLAS): a Randomized Clinical Trial.

Individual participant data are available to other researchers for clinical research purposes upon reasonable request to the principal investigator

Comparison of PLD-Q scores 4 weeks after the procedure, adjusted for baseline PLD-Q score.

PLD-Q score at 1, 6 and 12 months after intervention, adjusted for baseline

PLD-Q individual symptom scores at 1, 6 and 12 months after intervention, compared to baseline

SF-36 Mental Component Score at 1, 6 and 12 months after intervention, adjusted to baseline

SF-36 Physical Component Score at 1, 6 and 12 months after intervention, adjusted to baseline

EQ-5D-5L score at 1, 6 and 12 months after intervention, adjusted to baseline

Liver and cyst volume with CT before and 12 months after the intervention

Liver and cyst volume in cases of recurrence of symptoms

Cyst volume with ultrasound, at baseline and 1, 6 and 12 months after intervention.

Adverse events (according to Clavien-Dindo)

Re-intervention rates during 12 months follow-up.

Cost-effectiveness of both procedures iPCQ 1, 6 and 12 months after intervention, adjusted for baseline

Cost-effectiveness of both procedures iMCQ 1, 6 and 12 months after intervention, adjusted for baseline

Gastrointestinal Agents

Octreotide

0.5 mL CAM2029 10 mg, subcutaneous (SC) injection, once weekly

0.5 mL CAM2029 10 mg, SC injection, every 2 weeks and 0.5 mL placebo, SC injection, once every 2 weeks (alternating with CAM2029 dosing)

0.5 mL placebo, SC injection, once weekly

CAM2029

Placebo

Joost Drenth, MD

The purpose of the trial is to compare the effectiveness and safety of 2 treatment regimens of CAM2029 (given weekly or every 2 weeks) to placebo in participants with symptomatic PLD, either isolated as in autosomal dominant PLD (ADPLD) or associated with autosomal dominant polycystic kidney disease (ADPKD).

In the Treatment Period of the trial, participants will be allocated at random to 1 of the 3 treatment arms in a 1:1:1 ratio. After completing the Treatment Period (53 weeks) participants may proceed to a 24-week open-label extension part of the trial and then only receive the same CAM2029 treatment.

The active ingredient in CAM2029, octreotide, is administered as a subcutaneous depot using Camurus' FluidCrystal® technology.

A Trial to Assess the Efficacy and Safety of Octreotide Subcutaneous Depot in Patients With PLD

A Randomized, Placebo-controlled, Double-blind, Multi-center Trial to Assess Efficacy and Safety of Octreotide Subcutaneous Depot (CAM2029) in Patients With Symptomatic Polycystic Liver Disease

Change from baseline to Week 53 in htTLV as determined by MRI volumetry

Key secondary endpoint. Change from baseline to Week 53 in the PLD-S measure score

Change from baseline in htTLV as determined by MRI volumetry

Change from baseline in the PLD-S measure score

Change from baseline in htTKV as determined by MRI volumetry

Change from baseline in eGFR, assessed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) cystatin C equation using serum concentrations of creatinine and cystatin C

Change from baseline in the PLD-I measure score

Camurus AB

Ursodeoxycholic Acid

This group will receive standard care (no treatment)

The intervention group will receive 15-20mg/kg/day UDCA for 24 weeks

Joost PH Drenth, dr.

Rationale: Polycystic liver disease (PLD) is a rare disorder characterized by \>20 fluid-filled hepatic cysts. Polycystic livers are present in the combination with renal cysts as a manifestation of autosomal dominant polycystic kidney disease (ADPKD), or isolated in the absence of renal cysts as autosomal dominant polycystic liver disease (ADPLD or PCLD). PLD patients are confronted with symptoms caused by the mass effect of their polycystic liver every day for the rest of their life. There is no standard therapeutic option for symptomatic PLD patients. Current options are fairly invasive or their efficacy is only moderate.

Preliminary data in our research lab have shown that ursodeoxycholic acid (UDCA) inhibited the proliferation of polycystic human cholangiocytes in vitro through the normalization of the intracellular calcium levels in cystic cholangiocytes. The investigators also found that daily oral administration of UDCA for 5 months to polycystic kidney disease (PCK) rats, an animal model of ARPKD that spontaneously develops hepato-renal cystogenesis, resulted in inhibition of hepatic cystogenesis.

The investigators hypothesize that UDCA is an effective therapeutic tool in reducing liver volume in PLD.

Objective: First, to demonstrate whether UDCA-therapy is effective in reducing total liver volume in PLD patients. Second, the investigators want to assess if UDCA modifies quality of life. Finally, the investigators want to assess safety and tolerability.

Study design: International, multicenter, randomized, controlled trial Study population: 34 subjects (18 ≤age ≤ 80 years) suffering from symptomatic polycystic liver disease with underlying diagnosis of (PCLD or ADPKD), defined as ≥ 20 liver cysts on CT-scan and liver volume of ≥ 2500. Symptomatic is defined as Eastern Cooperative Oncology Group- Performance Score (ECOG-PS) ≥ 1 and having at least three out of ten PLD symptoms.

Intervention: The patients will be randomized (1:1) into two groups. One group of patients will receive 15-20mg/kg/day UDCA for 24 weeks. The other group will receive standard care.

Main study endpoint: Proportional change of total liver volume in UDCA treated patients versus non treated patients, as assessed by CT at baseline and 6 months.

We investigated whether ursodeoxycholic acid was able to reduce total liver volume in polycystic liver disease.

Ursodeoxycholic Acid as Treatment for Polycystic Liver Disease

An International, Multicenter, Randomized Controlled Clinical Trial Assessing the Efficacy of Ursodeoxycholic Acid as a Volume Reducing Treatment in Symptomatic Polycystic Liver Disease

Proportional change of total liver volume in UDCA treated patients versus non treated patients, as assessed by CT at baseline and week 24

Absolute total liver volume at baseline and end of treatment (week 24) will be measured

Improvement in Gastrointestinal Symptom score

Proportion reduction in total liver volume

Change in total kidney volume after 24 weeks

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Anti-Inflammatory Agents

Other Dietary Supplements

Prednisone

Mycophenolic Acid

Tacrolimus

Sirolimus

Benzocaine

Temsirolimus

MTOR Inhibitors

Glucocorticoids

Hormones

Hormone Antagonists

Immunosuppressive Agents

Immunologic Factors

Calcineurin Inhibitors

Enzyme Inhibitors

Anti-Bacterial Agents

Antibiotics, Antitubercular

Antitubercular Agents

Clotrimazole

Miconazole

Antifungal Agents

Tannic Acid

Tacrolimus, mycophenolate mofetil, and prednisone

Sirolimus, mycophenolate mofetil, and prednisone

Tacrolimus 6-10 mg/day (maintain trough levels of 8-10 ng/mL)

Sirolimus 3-5 mg/day (maintain high-performance liquid chromatography (HPLC) blood level 10-15 ng/mL)

Mycophenolate Mofetil

Patrick Dean, M.D.

QI Qian, MD

The purpose of this study is to see if one kind of immunosuppressive drug has better effects for the patient's polycystic liver disease than another type. Tacrolimus and Sirolimus are the two immunosuppressive drugs that will be compared for this study. Both drugs have been commonly prescribed to prevent rejection.

Autosomal dominant polycystic kidney disease (ADPKD) is a life-threatening monogenic disease with a prevalence of 1 in 400-1000 livebirths. ADPKD is caused by mutations to polycystic kidney disease 1 gene (PKD1) (approximately 85% of cases) or polycystic kidney disease 2 gene (PKD2) (the remaining 15%) gene, encoding polycystin-1 (PC1) and polycystin-2 (PC2), respectively. PC1 is a putative cell-surface, receptor-like protein with yet to-be-identified ligand(s), and PC2 a channel protein with a high conductance to Ca2+.

Polycystic liver disease (PLD) is the most common extra-renal manifestation in ADPKD, present in \> 90% of ADPKD patients by age 30. Liver cysts in ADPKD originate from biliary micro-hamartoma or focal proliferations of biliary ductules and from peribiliary glands. Excessive proliferation of biliary epithelial cells, combined with neovascularization, altered cell-extracellular matrix (ECM) interaction/ECM remodeling and cAMP-mediated fluid secretion, is required for the development and expansion of PLD liver cysts.

PLD may become symptomatic with acute complications such as cyst hemorrhage, rupture and infection. Chronic symptoms are frequently associated with massively enlarged PLD, including abdominal distension and pain; dyspnea; gastroesophageal reflux and early satiety which may lead to malnutrition; mechanical lower back pain; obstruction of the inferior vena cava, hepatic and portal veins (leading to dialysis-associated hypotension, hepatic venous outflow obstruction, and portal hypertension) and biliary obstruction. Currently, apart from invasive interventions such as cyst aspiration with sclerosis, cyst fenestration combined hepatic resection and cyst fenestration, liver transplantation and, rarely, selective hepatic artery embolization, no medical therapy is available.

The objective of this study is to conduct a prospective, open-label, randomized trial to examine the effect of sirolimus on total liver volume in kidney transplant recipients with ADPKD.

Four weeks following kidney transplant, subjects will undergo iothalamate clearance measurement, 24-hour urine collection and protein measurement and physical examination by a transplant surgeon. Patients will be randomized to receive either sirolimus-based immunosuppression or to continue tacrolimus-based immunosuppression unless one of the following conditions are noted:

1. Complications of the kidney transplant incision, including, but not limited to: superficial wound infection, deep wound infection, and fascial dehiscence
2. Iothalamate clearance measurement less than 40 mL/min/1.72m\^2
3. Urinary protein excretion greater than 800 mg/24 hours. Subjects with the above conditions will continue to receive tacrolimus-based immunosuppression at the discretion of the treating physician/surgeon.

Enrolled subjects will undergo abdominal and pelvic CT scans within 3 months before or after kidney transplantation and at one, two, and three years after kidney transplantation.

Polycystic Liver Disease in Kidney Transplant

Single Center, Open-label Randomized Prospective Trial: Effect of Sirolimus on Polycystic Liver Disease

Liver volume at 2 years will be compared between the sirolimus and control (tacrolimus) groups using analysis of covariance (ANCOVA).

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
A GnRH Agonist IN Pre-menopausal Women STudy to Treat Severe Polycystic Liver Disease	NCT05478083	Polycystic Live... Autosomal Domin...	Leuprorelin	18 Years - 45 Years	University Medical Center Groningen
Development and Assessment of The Polycystic Liver Disease Questionnaire (PLD-Q).	NCT02173080	Polycystic Live...	PLD-Q	18 Years -	Mayo Clinic
Assessment of Treatment With Laparoscopic Fenestration or Aspiration Sclerotherapy for Large Symptomatic Hepatic Cysts	NCT05500157	Liver Cyst Polycystic Live... Autosomal Domin... Autosomal Domin...	aspiration scle...	18 Years - 75 Years	Radboud University Medical Center
Assessment of Treatment With Laparoscopic Fenestration or Aspiration Sclerotherapy for Large Symptomatic Hepatic Cysts	NCT05500157	Liver Cyst Polycystic Live... Autosomal Domin... Autosomal Domin...	aspiration scle...	18 Years - 75 Years	Radboud University Medical Center
A Trial to Assess the Efficacy and Safety of Octreotide Subcutaneous Depot in Patients With PLD	NCT05281328	Polycystic Live...	CAM2029 Placebo	18 Years -	Camurus AB
Ursodeoxycholic Acid as Treatment for Polycystic Liver Disease	NCT02021110	Polycystic Live... Polycystic Kidn...	Ursodeoxycholic...	18 Years - 80 Years	Radboud University Medical Center
Polycystic Liver Disease in Kidney Transplant	NCT00934791	Polycystic Live...	Tacrolimus Sirolimus Mycophenolate M... Prednisone	18 Years -	Mayo Clinic
The Association Between Skeletal Muscle Mass and Severity of Polycystic Liver Disease and Polycystic Kidney Disease	NCT05215964	Polycystic Kidn... Polycystic Live... Muscle Loss	Renal artery em...	20 Years -	National Taiwan University Hospital
Development and Assessment of The Polycystic Liver Disease Questionnaire (PLD-Q).	NCT02173080	Polycystic Live...	PLD-Q	18 Years -	Mayo Clinic
Octreotide in Severe Polycystic Liver Disease	NCT00426153	Polycystic Kidn... Polycystic Live... Hepatomegaly Liver Diseases Kidney, Polycys... Abdominal Pain	Octreotide Placebo	18 Years - 80 Years	Mayo Clinic
Polycystic Liver Disease Registry (UK)	NCT04645251	Polycystic Live...		18 Years -	Portsmouth Hospitals NHS Trust

Spots Global Cancer Trial Database for polycystic liver disease