Updated Protocols for Anesthesia in Transplantation Surgery: A Literature Review

Abdul Karim Mohamed Almohamed *

Danat Al Emarat Hospital, United Arab Emirates.

*Author to whom correspondence should be addressed.


The human body is a complex working machinery. There is a lot that goes on within the body of a human being. However, the secret to its success lies in the fact that despite dealing with several stressful events, noxious stimuli, and infectious micro-organisms that are otherwise waiting to take over the body, its defense system and immune functioning do not let anything harmful slide by. It is always due to the diligent working of these complex fighting mechanisms that take care of all the noxious stimuli and ensure that the body keeps working smoothly and as effectively as ever. However, in extreme cases, things turn so negatively that the body’s organs and entire organ systems might be compromised. There are several underlying causes that lead up to this sequelae, however, the most common causes are the failure of these organs due to impending conditions that have been building up and causing other complications in the affected patient’s body for so long. Although replacing body organs is not as easy as surgically removing them, there are transplantation options available for several body organs. Bone marrow, liver, kidney, and heart are among the most commonly transplanted organs. However, there is an extensive criteria that needs to be fulfilled when opting for transplantation in an affected patient. Only if a patient fulfills all the carefully selected criteria is when they are given a clearance to proceed with the procedure. Just like this criteria, various other steps need to be assured as well in context of the operating teams, surgeons, and the anesthetic procedures. This review aims to deal with the perspective of anesthesia in patients undergoing transplantation surgeries. This review will go into the details of how an anesthesia is chosen for a particular patient, depending upon the complexity of their procedure. This, in turn, would help in educating the new physicians and anesthetists to become aware of how things proceed after a patient is kept on-list for a transplantation procedure.

Keywords: Transplantation, anesthesia, choice of anesthesia, heart transplantation, kidney transplantation, liver transplantation

How to Cite

Almohamed, A. K. M. (2023). Updated Protocols for Anesthesia in Transplantation Surgery: A Literature Review . Asian Journal of Medical Principles and Clinical Practice, 6(2), 327–333. Retrieved from https://journalajmpcp.com/index.php/AJMPCP/article/view/195


Download data is not yet available.


Grinyó JM. Why Is Organ Transplantation Clinically Important? Cold Spring Harb Perspect Med. 2013;3(6):a014985.

INSERM Collective Expertise Centre. Organ Transplantation: Research perspectives [Internet]. Paris (FR): Institut national de la santé et de la recherche médicale; 2008

(INSERM Collective Expert Reports). Available:http://www.ncbi.nlm.nih.gov/books/NBK24616/

Accessed on: 2023 Oct 14].

Bezinover D, Saner F. Organ transplantation in the modern era. BMC Anesthesiol. 2019;19:32.

Grinyó JM. Why Is Organ Transplantation Clinically Important? Cold Spring Harb Perspect Med. 2013;3(6):a014985.

Ghelichi-Ghojogh M, Mohammadizadeh F, Jafari F, Vali M, Jahanian S, Mohammadi M, et al. The global survival rate of graft and patient in kidney transplantation of children: a systematic review and meta-analysis. BMC Pediatr. 2022;22:503.

Nordham KD, Ninokawa S. The history of organ transplantation. Proc Bayl Univ Med Cent. 1954;35(1):124–8.

Al-Bar MA, Chamsi-Pasha H. Organ Transplantation. In: Contemporary Bioethics: Islamic Perspective [Internet] [Internet]. Springer; 2015.

Available:https://www.ncbi.nlm.nih.gov/books/NBK500177/Accessed on: 2023 Oct 14.

Vanholder R, Domínguez-Gil B, Busic M, Cortez-Pinto H, Craig JC, Jager KJ, et al. Organ donation and transplantation: a multi-stakeholder call to action. Nat Rev Nephrol. 2021;17(8):554–68.

Beyar R. Challenges in Organ Transplantation. Rambam Maimonides Med J. 2011 Apr 30;2(2):e0049.

O’Donnell FT. Preoperative Evaluation of the Surgical Patient. Mo Med. 2016;113(3):196–201.

Admass BA, Ego BY, Tawye HY, Ahmed SA. Preoperative investigations for elective surgical patients in a resource limited setting: Systematic review. Ann Med Surg. 2022;82:104777.

Hall A, Pike A, Patey A, Mortazhejri S, Inwood S, Ruzycki S, et al. Barriers to reducing preoperative testing for low-risk surgical procedures: A qualitative assessment guided by the Theoretical Domains Framework. PLOS ONE. 2022;17(12):e0278549.

Bock M, Fritsch G, Hepner DL. Preoperative Laboratory Testing. Anesthesiol Clin. 2016;34(1):43–58.

Bahar SG, Devulapally P. Pancreas Transplantation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Available:http://www.ncbi.nlm.nih.gov/books/NBK562338/

Accessed on: 2023 Oct 14.

Vitin AA. Perioperative care for organ transplant recipient: Time for Paradigm Shift. J Crit Care Med. 2019;5(3):87–9.

Nandhakumar A, McCluskey SA, Srinivas C, Chandy TT. Liver transplantation: Advances and perioperative care. Indian J Anaesth. 2012;56(4):326–35.

Singh S, Nasa V, Tandon M. Perioperative Monitoring in Liver Transplant Patients. J Clin Exp Hepatol. 2012;2(3):271–8.

Brezeanu LN, Brezeanu RC, Diculescu M, Droc G. Anaesthesia for Liver Transplantation: An Update. J Crit Care Med. 2020;6(2):91–100.

Rudnick MR, Marchi LD, Plotkin JS. Hemodynamic monitoring during liver transplantation: A state of the art review. World J Hepatol. 2015;7(10):1302–11.

Biais M, Nouette-Gaulain K, Cottenceau V, Vallet A, Cochard JF, Revel P, et al. Cardiac output measurement in patients undergoing liver transplantation: pulmonary artery catheter versus uncalibrated arterial pressure waveform analysis. Anesth Analg, table of contents. 2008;106(5):1480–6

De Pietri L, Mocchegiani F, Leuzzi C, Montalti R, Vivarelli M, Agnoletti V. Transoesophageal echocardiography during liver transplantation. World J Hepatol. 2015;7(23):2432–48.

Feltracco P, Biancofiore G, Ori C, Saner FH, Della Rocca G. Limits and pitfalls of haemodynamic monitoring systems in liver transplantationsurgery. Minerva Anestesiol. 2012;78(12):1372–84.

Zhang K, Tian Y, Zhao Y, Tian M, Li X, Zhu Y. Incidence and Risk Factors for Surgical Site Infection after Femoral Neck Fracture Surgery: An Observational Cohort Study of 2218 Patients. BioMed Res Int. 2022;2022:5456616.

Cao YH, Chi P, Zhao YX, Dong XC. Effect of bispectral index-guided anesthesia on consumption of anesthetics and early postoperative cognitive dysfunction after liver transplantation: An observational study. Medicine (Baltimore). 2017;96(35):e7966.

Trzebicki J, Flakiewicz E, Nowakowski P, Kosieradzki M, Lisik W, Chmura A. Is external jugular venous pressure a good predictor of volume status in kidney graft recipients? Transplant Proc. 2009;41(8):3033–5.

Shen L, Tabaie S, Ivascu N. Viscoelastic testing inside and beyond the operating room. J Thorac Dis. 2017;(Suppl 4):S299–308.

Baxi V, Jain A, Dasgupta D. Anaesthesia for Renal Transplantation: An Update. Indian J Anaesth. 2009;53(2):139–47.

Srivastava D, Tiwari T, Sahu S, Chandra A, Dhiraaj S. Anaesthetic Management of Renal Transplant Surgery in Patients of Dilated Cardiomyopathy with Ejection Fraction Less Than 40%. Anesthesiol Res Pract. 2014:525969.

Ricaurte L, Vargas J, Lozano E, Díaz L, Organ Transplant Group. Anesthesia and kidney transplantation. Transplant Proc. 2013 45(4):1386–91.

Jaszczuk S, Natarajan S, Papalois V. Anaesthetic Approach to Enhanced Recovery after Surgery for Kidney Transplantation: A Narrative Review. J Clin Med. 2022;11(12):3435.