Anaesthesia for kidney transplantation

Abstract

In 1954, Joseph Murray performed the first successful renal transplantation on identical twins. Due to improvements in immunosuppressant medication and surgical techniques in the past decades, the organ survival rate has increased significantly. A study comparing kidney recipients, patients on the waiting list and patients on dialysis showed a significant reduction in mortality in the patients that have been transplanted.1 The kidney donor pool has been expanded and even marginal organs are being transplanted, as they provide survival benefit in comparison to dialysis.2,3 The indication for renal transplantation was extended to older patients with worse medical prognosis than before.4 Particularly the recipients in the Eurotransplant Senior Program “old-for-old†require an individualised intra- and postoperative management by the attending anaesthetist.5