The transplant recipients have considerable medical,physiological, and pharmacological problems; therefore, a clearunderstanding of the physiology of the transplanted organ, thepharmacology of the immunosuppressive drugs, and theunderlying surgical conditions is essential for these patients tosafely undergo anesthesia and surgery.Local, regional, or general anesthesia can be safelydelivered to transplant recipients, and a successful anestheticand perioperative management can be provided.Keywords: transplant recipients, immunosuppressive drugs, Local,regional, or general anesthesia, anesthetic and perioperative management,end-stage organ disease, lung, liver, heart, kidney, intestine, pancreas.