Anesthesia for renal transplantation

Abstract

Renal transplantation has become a relatively common procedure that clinicians now offer to patients with an increasingly challenging array of medical problems; yet the mortality associated with anesthesia for renal transplantation remains low. Preoperatively dialysis is of fundamental importance because it reverses many of the biochemical abnormalities caused by uremia. Modern anesthetic agents provide a greater margin of safety. There is no single or correct anesthetic for all patients with renal failure. With a clear understanding of the pharmacokinetics of anesthetic agents and an appreciation of the changes incurred by renal failure, a wide variety of agents can and have been used successfully. During renal transplantation, the anesthesiologist must optimize volume status, perfusion pressure, and other factors that affect the function and survival of the renal graft.