[Occurrence of suspicious changes in cervix cytology in women after liver transplantation].
After transplantation the necessary immunosuppressive therapy predisposes to the development of de novo cancers. From January 1989 to April 1994 we collected PAR smears of 98 women before and repeatedly after liver transplantation. After surgery all women received as immunosuppressive agents either Cyclosporin A or FK 506 as long-term medication. In seven patients (8.5%) who had a normal cervical cytology before transplantation a suspicious PAP smear was found on average 11 months after transplantation. In five cases a histological verification (exploratory excision, coning of the cervix) was made. In two cases we found a CIN III. Possible causes for the higher incidence of dysplasia of the cervix observed in the transplant patients are discussed. Similar to kidney transplant recipients female liver transplant recipients are at higher risk of developing cervical dysplasias and neoplasias. Accelerated development of malignancy seems likely. The influence on the cervical cells of both immunosuppressive drugs Cyclosporin A and FK 506 seems to be of a similar nature. Recommendations for the gynaecological care of female liver transplant recipients treated with immunosuppressive therapy are given.
David
M
M
Universitätsklinikum R. Virchow, Geburtshilflich-gynäkologische Abteilung, Freie Universität Berlin.
Olbrich
C
C
Neuhaus
R
R
Lichtenegger
W
W
D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000276:immunology / Q000473:pathology; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D016031:Liver Transplantation / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D065006:Papanicolaou Test; D012307:Risk Factors; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects; D002578:Uterine Cervical Dysplasia / Q000276:immunology / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000473:pathology*; D014626:Vaginal Smears
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus