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


METHODS
Retrospective, non-interventional study from two centers.


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


METHODS
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.


METHODS
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.
Department of Gynecology and Gynecological Oncology, Gynecological Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Julian
J
Marschalek
Department of Gynecology and Gynecological Oncology, Gynecological Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Samir
S
Helmy
Division of Nephrology and Dialysis, Department of Medicine Ill, Medical University of Vienna, Vienna, Austria.
Alice
A
Schmidt
Department of Gynecology and Gynecological Oncology, Gynecological Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Stephan
S
Polterauer
Department of Gynecology and Gynecological Oncology, Gynecological Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Martha
M
Sobulska
Division of Transplantation, Department of Surgery, Medical University of Vienna, Vienna, Austria.
Georg P
GP
Gyoeri
Department of Gynecology and Gynecological Oncology, Gynecological Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Christoph
C
Grimm
D000328:Adult; D000367:Age Factors; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D016017:Odds Ratio; D051437:Renal Insufficiency / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology*; D055815:Young Adult
Kidney transplantation; cervical intraepithelial neoplasia; genital dysplasia; gynecological screening; human papillomavirus