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Anesthesia and Transplantation.
  1. PAUL SPIERS, Consultant in Intensive Care Medicine and Anaesthesia
  1. Leicester General Hospital NHS Trust, Leicester, UK

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    Anesthesia and Transplantation. Edited by Michael D Sharpe, Adrian W Gelb. (Pp 512; £95.) Butterworth Heinemann, 1999. ISBN 0-7506-9664-8.****

    The spelling of anaesthesia in the title hints at its Canadian/American origins. The editors are based in Ontario, Canada with the majority of the 63 contributing authors from the USA or Canada. The book is well written and thoughtfully assembled to give an overview of the last 50 years of transplant surgery and its problems. The book can be described in four parts.

    The first five chapters introduce the topic with a summary of the history behind transplantation, the problems behind organ resources and consent for donation, declaration of brain death and the management of the organ donor, and an excellent chapter on mechanical devices as a bridge to transplantation. The second section consists of seven “how to do it” chapters dealing with the practical aspects of anaesthesia and surgery for all the major organ transplants. The third section of the book deals with the ongoing management problems of the transplant recipient with interesting chapters on the intensive care unit management of transplantation related problems, anaesthesia for the previously transplanted patient, immunosuppresive agents, and the management of infections. The book ends with an examination of the ethical and psychosocial issues and a glimpse into the future.

    This book is an excellent and timely review of the methods available and current problems surrounding transplantation at the end of the 20th century. It will appeal to old hands in the field as well as trainee doctors who wish to develop an interest in transplantation anaesthesia or intensive care.

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