Perioperative considerations in kidney transplantation: An anaesthesiologist’s perspective

Table 1 Preoperative considerations for kidney transplantation

Area of management	Anaesthesia considerations
Preoperative evaluation	Detailed history of kidney disease, dialysis, urine output, blood transfusion, previous transplant or surgery, pregnancy, comorbidities, multisystem involvement, medications, and drug abuse
	Detailed donor evaluation
	Physical assessment of the recipient for fitness of surgery
	Routine investigations for surgery
	Special testing to decide transplant candidacy
	Secondary evaluation by other specialists, if needed
	Correction of anemia
Preoperative optimization	Weight reduction, exercise, and nutritional build-up
	Smoking and alcohol cessation at least 4-6 weeks before surgery
	Incentive spirometry
	Preoperative haemodialysis
	Repeat electrolytes and coagulation profile on the day of surgery
Preoperative advice	Continue antihypertensive, antianginals, beta-blockers
	Discontinue oral hypoglycemics, anticoagulants, and antiplatelets
	Fasting: As per standard fasting guidelines, prolonged in patients with gastroparesis, diabetes, and ascites
	Anti-anxiety: Short-acting benzodiazepine
	Oral antacid: H2 receptor blockers or proton pump inhibitors