Cardiovascular anesthesia: Edited By Stefan De HertAnaesthesia for noncardiac surgery in the heart transplant recipientBlasco, Lucrecia Maríaa; Parameshwar, Jayanb; Vuylsteke, AlainaAuthor Information aDepartment of Anaesthesiology and Intensive Care, UK bCardio-Pulmonary Transplantation Unit, Papworth Hospital, Cambridge, UK Correspondence to Alain Vuylsteke, Consultant in Anaesthesia and Intensive Care, Director of Critical Care, Department of Anaesthesiology and Intensive Care, Papworth Hospital, Cambridge, United Kingdom Tel: +44 1480 830541; e-mail: [email protected] Current Opinion in Anaesthesiology: February 2009 - Volume 22 - Issue 1 - p 109-113 doi: 10.1097/ACO.0b013e32831c83e0 Buy Metrics Abstract Purpose of review Anaesthetizing a patient who benefited from a heart transplant will undoubtedly fascinate any anaesthetist. Basic principles need to be adhered to in order to ensure that no unnecessary harm is caused to these patients. Furthermore, the conscientious anaesthetist will want to remain abreast of the advances in the understanding of physiological changes occurring over the years after transplantation and the continuous innovations in the field of immunosuppression. Recent findings Understanding of the mechanisms surrounding cardiac allograft vasculopathy and insight into the possibility of reinnervation are continuously evolving; but changes in therapeutic regimens in an attempt to lower side effects have probably a greater impact on day-to-day clinical practice. Conclusion Understanding how to administer fluids adequately to a transplant patient; how to use direct vasoactive agents; how to manage the infectious risk; and the need to be aware of the multiple side effects of immunosuppressive regimens are essential to recognize, prevent or treat possible perioperative complications. © 2009 Lippincott Williams & Wilkins, Inc.