Prevalence of genital dysplasia after kidney transplantation--a retrospective, non-interventional study from two centers

Acta Obstet Gynecol Scand. 2015 Aug;94(8):891-7. doi: 10.1111/aogs.12663. Epub 2015 May 23.

Abstract

Objective: Renal transplant patients are at increased risk for human papillomavirus-related malignancies of the lower genital tract. Our aim was to describe the incidence of genital dysplasia, assess the most common cervical cancer screening intervals and identify independent risk factors for the development of genital dysplasia in renal transplant patients.

Design: Retrospective, non-interventional study from two centers.

Setting: Post-transplant nephrologic follow-up visit at the Medical University of Vienna and a Viennese teaching hospital.

Population: 262 consecutive female renal transplant patients with renal transplant performed between 1980 and 2012 at the Medical University of Vienna.

Methods: Sociodemographic patient characteristics, frequency of gynecological examinations, histo- and cytopathological test results were collected.

Main outcome measures: Dysplasia rates in renal transplant patients.

Results: 16 patients (6.2%) with genital dysplasia after renal transplant were observed. The 1-year, 3-year and 10-year proportional incidence rates for genital dysplasia in general and cervical dysplasia in particular were 1.3 and 1.3%, 3.3 and 2.7%, and 13.6 and 12.0%, respectively. Patients attended cervical cancer screening on a regular basis once a year in 82.7% of cases. In multivariate analysis re-transplantation [odds ratio 12.1 (1.5-96.3)], and renal transplant at a young age [odds ratio 0.6 (0.4-0.9)] were identified as independent risk factors for the development of female genital dysplasia.

Conclusions: Female renal transplant patients have an increased risk for the development of genital dysplasia in general and of cervical dysplasia in particular. Within this cohort, women at a young age at the time of transplantation and after re-transplantation are at highest risk for the development of genital dysplasia.

Keywords: Kidney transplantation; cervical intraepithelial neoplasia; genital dysplasia; gynecological screening; human papillomavirus.

MeSH terms

  • Adult
  • Age Factors
  • Carcinoma in Situ / epidemiology*
  • Carcinoma in Situ / pathology
  • Female
  • Genital Neoplasms, Female / epidemiology*
  • Genital Neoplasms, Female / pathology
  • Humans
  • Incidence
  • Kidney Transplantation / adverse effects*
  • Middle Aged
  • Odds Ratio
  • Renal Insufficiency / etiology
  • Renal Insufficiency / pathology
  • Renal Insufficiency / surgery*
  • Retrospective Studies
  • Risk Factors
  • Uterine Cervical Dysplasia / epidemiology*
  • Young Adult