More than 17000 patients currently live in Germany who have had organ transplants. The implications of this for the anaesthetists are that they are very likely to be confronted by such a patient at some point during their active career. Besides the preoperative assessment which includes that of the function of the transplanted organ, appropriate immunosuppression poses a particular challenge. Close collaboration with both patients and their transplant specialists is essential to preempt the perioperative consequences and plan continuation of immunosuppression. Strictly aseptic measures are mandatory as well as detailed evaluation of the risk-benefit balance of all invasive procedures.There are no significant differences between the anaesthetic approaches and agents in transplant and non-transplant patients. However, in the latter group, homeostasis of all organ systems should be more focused on.
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