Abstract
The elderly comprise a growing fraction of the population with increasing demand for transplant services. Presently, 21% of subjects registered on the organ transplant list are older than 65 and around 18% of all transplants are carried out in the elderly. Despite the increased acceptability of transplantation in the elderly, aged patients still pose greater challenges due to decreased physiological reserve, frailty, and coexisting disease. Indications and outcome of organ transplantation in the elderly differ from the young. Transplantation success depends on careful evaluation and patient selection with optimal perioperative management. The anaesthesiologist has a unique role in the success of transplant surgery by contributing to preoperative assessment and intraoperative and postoperative care. This chapter addresses the physiological changes, outcome, and perianaesthetic management of the elderly transplant recipient, with emphasis on liver, kidney, and multivisceral transplantation.