RT Book, Section A1 Meinecke, Barbara A2 Ellinas, Herodotos A2 Matthes, Kai A2 Alrayashi, Walid A2 Bilge, Aykut SR Print(0) ID 1176458825 T1 Anesthesia for Renal Transplantation T2 Clinical Pediatric Anesthesiology YR 2021 FD 2021 PB McGraw Hill PP New York, NY SN 9781259585746 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1176458825 RD 2024/03/29 AB FOCUS POINTSCongenital and structural abnormalities are the leading causes of pediatric renal failure.The adult approach, curvilinear incision and retroperitoneal placement of the donor kidney, is the current surgical technique.Careful review of preoperative medications is warranted, especially angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) that may affect cardiac hemodynamics intraoperatively.Vascular access can be a challenge and may require a preoperative placement in the interventional radiology suite for successful placement.Sugammadex has been proven to be safe and effective in patients with renal failure, perhaps with slower recovery compared with patients with normal renal function. Sugammadex and sugammadex-rocuronium complexes are cleared by hemodialysis.Providing optimal hemodynamics for graft reperfusion is extremely important; this goal can be accomplished with the administration of crystalloid, colloid, blood products, and/or inotropic infusions.Causes of graft loss in the immediate postoperative period include primary nonfunction of the new organ and thrombosis of vessels.Malignancy is a potential complication after transplant surgery with post-transplant lymphoproliferative disease (PTLD) being the most common, developed from latent Epstein–Barr virus (EBV).