Pediatric Transplant Patients and Their Medical Conditions/Therapies: Implications for Perioperative Management

Transplantation in pediatric patients has become a common occurrence. Each year more than 2000 children receive solid organ transplants in the United States and this number is expected to increase in the future (UNOS database annual report 2001). Post transplant children may present for anesthesia and surgeries that are routine in pediatric patients (myringotomy with tubes, tonsillectomies, strabismus surgery, inguinal hernia repair) but have special implications in these patients. In this discussion we will review the common solid organ transplants that are being performed in pediatric patients including the indications for transplantation, currently administered immunosuppression agents and the special anesthetic considerations in patients with transplanted organs.