Perioperative management of special populations: immunocompromised host (cancer, HIV, transplantation).
Optimal perioperative care of the immunocompromised patient requires an understanding of the consequences of disease-specific pharmacologic therapies. The toxicity profile of these therapies can strongly influence the decision algorithms for delivering care in the perioperative period. In this manuscript, the investigators describe the potential effects of drugs commonly used for treatment of patients with cancer, HIV, or transplanted organs, and the impact of these drugs on the care of these patients in the perioperative setting. The article addresses such topics as cardiotoxicity, pulmonary toxicity, hepatotoxicity, genitourinary toxicity, neurotoxicity, myelosuppression, cutaneous toxicity, mitochondrial toxicity, lipodystrophy, hypersensitivity, and liver dysfunction. The article also describes the use of corticosteroids, calcineurin inhibitors, sirolimus, and antimetabolites.
Desai
Dev M
DM
Division of General and Transplant Surgery, Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA.
Kuo
Paul C
PC
D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009369:Neoplasms / Q000276:immunology* / Q000401:mortality; D016377:Organ Transplantation / Q000401:mortality; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control*; D011379:Prognosis; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000379:methods / Q000401:mortality; D015996:Survival Rate; D014181:Transplantation Immunology / Q000502:physiology*; D016896:Treatment Outcome