Anesthesia and graft‐vs‐host disease after hematopoietic stem cell transplantation

Perioperative Management of a Recipient of Allogenic Hematopoietic Stem Cell Transplant Undergoing Neurosurgery

“…GVHD can rarely affect both the central and peripheral nervous systems in the form of cerebrovascular disease, demyelinating disease, immune-mediated encephalitis, PTLDs, myositis, neuropathies, and myasthenia gravis. 2…”

“…GVHD can rarely affect both the central and peripheral nervous systems in the form of cerebrovascular disease, demyelinating disease, immune-mediated encephalitis, PTLDs, myositis, neuropathies, and myasthenia gravis. 2 There are specific concerns regarding different chemotherapeutic agents, which are extensively discussed elsewhere. 3 The anesthetic implications of the different immunomodulatory agents and radiotherapy are described in ►Table 1.…”

Anesthetic concerns in recipients of hematopoietic stem cell transplant

“…Therefore, it is prudent to delay elective surgeries before engraftment and while the patient is on immune-modulators. [ 5 ] Moreover, anesthesiologist should be aware of long-term adverse effects of chemotherapeutic drugs including potential difficult airway due to gum hypertrophy (cyclosporine) and lymph node enlargement as part of post-transplant lymphoproliferative disorder (PTLD). Acute GVHD may involve different organ systems, leading to potentially dreaded complications like acute lung injury, veno-occlusive disease of liver, thrombotic micro angiopathy (TMA) which should be evaluated during the pre-anesthetic check-up.…”

“…Acute GVHD may involve different organ systems, leading to potentially dreaded complications like acute lung injury, veno-occlusive disease of liver, thrombotic micro angiopathy (TMA) which should be evaluated during the pre-anesthetic check-up. [ 5 ]…”