Atypical Cervical Cytology in Solid-Organ Transplant Patients: 20 Years of Experience in a Single Center

Clinical findings support the critical importance of cervical screening and the management of abnormal cervical cytology results in female organ transplant recipients. We evaluated the incidence and prognosis of atypical cervical lesions in women who are kidney and liver transplant recipients at our organ transplant center.

We performed a retrospective cohort study of patients at Başkent University, Ankara, Türkiye, from March 2003 to January 2023. We included women who underwent at least 1 cervical cytology after kidney or liver transplant. The Bethesda System was used to classify cervical cytology results. We analyzed follow-up data by using descriptive statistics.

Our study included 124 patients, with 98 (79%) being kidney transplant recipients and 26 (21%) being liver transplant recipients. The median age was 37.5 years. Atypical cervical cytology was detected in 34 patients (27.4%). The distribution of cervical cytology results was 90 with normal cytology (72.6%), 10 with atypical squamous cells of undetermined significance (8.1%), 23 with low-grade squamous intraepithelial lesion (18.5%), and 1 with high-grade squamous intraepithelial lesion (0.8%). Among these, 42 patients (33.9%) underwent colposcopy, revealing abnormal results in 10 patients (23.8%), including 1 (2.38%) with cervical cancer.

The findings underline the significant prevalence of atypical cervical lesions among solid-organ recipient patients, highlighting the need for proactive cervical screening and management strategies in this high-risk population.