Anesthetic considerations for an adult heart transplant recipient undergoing noncardiac surgery: a case report.

Approximately 3,500 Americans undergo heart transplantation each year. A portion of this patient population will possibly present later for an elective noncardiac surgery. Anesthesia professionals can be tasked to assess and provide the anesthesia management for heart transplant recipients undergoing a noncardiac surgical procedure. A 57-year-old man with a complicated cardiac history before undergoing heart transplantation was scheduled to undergo a right inguinal hernia repair. The patient underwent general anesthesia and had an uneventful course of surgery and recovery. Management of the patient with a heart transplant includes consideration of the altered physiology of a denervated heart; the perioperative anesthetic considerations specific to this patient population; and the risks of rejection, infection, and pharmacologic interactions brought about by immunosuppression. The purposes of this case report were to discuss the indications for the perioperative care of heart transplant recipients undergoing noncardiac procedures, and to discuss the evidence-based literature to provide delivery of safe and effective patient care.