Cervical Abnormalities and Gynecological Neoplasms in Heart Transplanted Recipients

Abstract

Purpose Cervical cancer is the most common gynecological cancer worlwide. Squamous intraepithelial lesions (SIL) are known precursors for carcinoma of uterine cervix and associated to infection by human papillomavirus (HPV). Several studies have shown an increased risk of malignant anogenital lesions in recipients of kidney and liver transplants compared to the general population, but there is less information in heart transplanted recipient Methods We conducted a retrospective unicentric study to analyze the prevalence of cervical abnormalities and gynecological neoplasms in cardiac transplant recipients Results From 1984 to 2017, 557 transplants were performed. 124 recipients were female. A total of 242 tumors have been registered in 129 patients. Of the 242 tumors 61% were cutaneous, 8% lymphoproliferative and 31% (75) were solid organ tumors. Of the 75 solid organ tumors, 19 have occurred in women; 3 were breast neoplasms and 10 were genital tumors; 2 located in the vulva and 8 SIL. The age of the recipients was 36 ± 14 years, all of them affected by non-ischemic cardiomyopathy (2 hypertrophic, 1 lupus cardiomyopathy, 1 congenital heart disease and 6 dilated cardiomyopathies). Time from the transplant to the diagnosis of the tumor was 79 ± 33 months. In 6 of the 8 patients with SIL concomitant HPV infection was confirmed, in the remaining two this information was not available Conclusion In our serie, in female recipients of heart transplantation gynecological tumors represent 68% of solid organ tumors. SIL are the main gynecological tumor. Taking in account the association of SIL with HPV infection, vaccination of patients who are candidates for a heart transplant would be beneficial in the prevention of uterine cervix neoplasms