title: Prevention of Posttransplant Lymphoproliferative Disorder in Pediatric Patients With a Liver Transplant.
abstract: OBJECTIVE
  This study sought to evaluate in pediatric liver transplant recipients the effects of hybrid antiviral therapy on the rate of posttransplant lymphoproliferative disorder.
  
  
  METHODS
  All pediatric patients (87 cases) who had undergone a liver transplant between April 2011 and March 2012 took part in the study and received hybrid antiviral treatment (case group). Epstein-Barr virus polymerase chain reaction was monitored intermittently. The results were compared to those of a historical control group including 117 pediatric patients who received a liver transplant between April 2009 and March 2011. Follow-up was 27 to 47 months in the control group and 12 to 26 months in the case group.
  
  
  RESULTS
  Posttransplant lymphoproliferative disorder occurred in 12 patients in control group (10.2%) and 5 patients in case group (5.7%) (P = .249). Of 12 cases of posttransplant lymphoproliferative disorder, death occurred in 5 cases in the control group (41.7%), while no posttransplant lymphoproliferative disorder-associated death was seen in the case group (P = .086).
  
  
  CONCLUSIONS
  Although hybrid antiviral treatment did not result in a statistically significant decrease in posttransplant lymphoproliferative disorder and posttransplant lymphoproliferative disorder-associated mortality rates, considering the limited number of posttransplant lymphoproliferative disorder cases in this study, this decrease may be interpreted as noticeable, and we advise using this strategy for pediatric patients undergoing a liver transplant.
authors.affiliation: From the Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad; and the Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Aliakbarian
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Dehghani
authors.forename: Bita
authors.initials: B
authors.lastname: Geramizadeh
authors.forename: Saman
authors.initials: S
authors.lastname: Nikeghbalian
authors.forename: Karamali
authors.initials: K
authors.lastname: Kasiri
authors.forename: Kourosh
authors.initials: K
authors.lastname: Kazemi
authors.forename: Ali
authors.initials: A
authors.lastname: Shamsaeefar
authors.forename: Ali
authors.initials: A
authors.lastname: Bahador
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Malekhosseini
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000367:Age Factors; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control* / Q000821:virology; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004854:Herpesvirus 4, Human / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D007223:Infant; D007492:Iran / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control* / Q000821:virology; D008297:Male; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D000077562:Valganciclovir; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D007166:Immunosuppressive Agents; D000077562:Valganciclovir; D015774:Ganciclovir