Anesthetic Considerations in Transplant Recipients for Nontransplant Surgery

Abstract

As solid organ transplantation increases and patient survival improves, it will become more common for these patients to present for nontransplant surgery. Recipients may present with medical problems unique to the transplant, and important considerations are necessary to keep the transplanted organ functioning. A comprehensive preoperative examination with specific focus on graft functioning is required. The anesthesiologist needs to pay close attention to considerations of immunosuppressive regimens, blood product administration, drug interactions as well as the risk and benefits of invasive monitoring in these immunosuppressed patients. This article reviews the post-transplant physiology and anesthetic considerations for patients after solid organ transplantation.

Review of anaesthetic management for cataract surgery in transplant recipients

“…ascites, pulmonary shunt, hyperdynamic state) also return to normal. 42,43 However, allograft liver has lost its autoregulatory ability, and is therefore susceptible to hypotensive injury. Most general and local anaesthetic agents can be safely used on liver transplant recipients.…”

“…Most general and local anaesthetic agents can be safely used on liver transplant recipients. [42][43][44] Kidney transplant. The transplanted kidney also loses its autoregulatory ability, becoming more susceptible to hypoperfusion injury.…”

“…In fact, cardiovascular complications are the leading cause of death (32%) in renal transplant recipients. 43 Pancreas transplant. Pancreas transplantation provides an effective method for glycaemic control.…”

“…Furthermore, these patients are also at risk of other diabetes-related complications, such as autonomic neuropathy, delayed gastric emptying and increased risk of aspiration. 42,43 Intestine transplant. Intestinal or multi-visceral transplantation is a therapeutic option for patients with intestinal failure in children and adults.…”

“…Graft rejection is the biggest problem and the leading cause of morbidity and mortality. 43 Bone marrow transplant. Bone marrow transplantation (autologous or allogeneic) has been the main therapeutic modality for patients with life-threatening haematological diseases, especially children.…”