The anesthetic management of a child with chronic hypotension for renal transplantation.

The anesthetic management of renal transplant recipients requires the maintenance of an adequate perfusion pressure to ensure viability of the donated kidney. A common finding among patients with end-stage renal disease is chronic hypertension. We report a case involving a 2-year-old child with an age-adjusted blood pressure below normal, undergoing transplantation of an adult cadaveric kidney, during which high-dose vasopressor medications were used to sustain the child's blood pressure at above-normal levels to help ensure perfusion of the adult allograft.