Peri-operative considerations in the patient with primary immune deficiency: a review.

Overview

BACKGROUND: Patients with inherited immune deficiency diseases often require surgical procedures, and their immune defects may predispose them to surgical complications. METHODS: A thorough review of pertinent literature and current practice guidelines on surgery in patients with immune deficiency. RESULTS: Peri-operative infections are a key, but not a singular, consideration in managing patients with a primary immune deficiency. Bleeding diathesis, gastrointestinal complications, pulmonary complications, and poor incision healing may also be idiosyncratic features unique to particular immune deficiency diseases. Patients with complex genetic syndromes that include immune deficiency also may display non-immunologic abnormalities that are equally important to surgical care. CONCLUSION: Greater awareness of primary immune deficiencies and a comprehensive evaluation of such patients in close consultation with an immunologist can minimize surgical complications and optimize patient outcomes.