Anaesthesia for renal transplant: Recent developments and recommendations

SummaryFollowing improvements in perioperative care and postoperative immunosuppression, renal transplant (RT) became the best therapeutic option for end-stage renal failure (ESRF). Problems encountered by anaesthetists in RT recipients include hypertension, ischaemic heart disease, congestive heart failure, anaemia, metabolic acidosis, hyperkalaemia, hyponatraemia and circulatory collapse. Although solutions to most of these have been found over the past 50 years, the RT procedure still carries significant risk of peri- and postoperative complications (mostly cardiovascular) and even fatal outcome. This paper reviews approaches to well-known issues regarding anaesthesia in RT and new anaesthetic challenges.