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Anesthesia and Transplantation

Michael D. Sharpe, Adrian W. Gelb (Eds.). Butterworth Heinmann Ltd, 1999. 512 pages. $125.00 (US). ISBN 0-7506-9664-8

Vancouver, BC.

The editors have attracted 61 international authors to contribute to this authoritative text covering all aspects of the care of the transplant patient that are of concern to anesthesiologists. Although the majority of contributors are anesthesiologists and transplant surgeons from North America, they have also included intensivists, immunologists, psychiatrists, pathologists, infectious disease physicians and transplantation co-ordinators in providing a global view of transplantation.

The anesthesia aspects of all the major transplant organs (heart, lung, liver, kidney, small bowel, pancreas, cornea) are described by recognized experts. Inevitably, other experts will dispute the details of management, but the views expressed are well supported, current and applicable to most environments. However, what differentiates this text from others with similar objectives is the space devoted to the other aspects of transplant care. Management of the organ donor is described in detail and hematological, infectious, nutritional and immunological considerations are well integrated into the text.

For this reviewer, highlights included a very well argued overview of the past, present and future of solid organ transplantation by Professor Sir Roy Calne (Cambridge, England) which discusses the difficult ethical issues of organ harvesting. These are further elaborated by Calvin Stiller and Cate Abbott (London, Ontario) in which the problems of xenotransplantation, use of organs from anencephalic infants and fetus are presented clearly. Most readers would be better to skip the confusing and disappointing introductory chapter "History of Organ Transplantation via the Two-way Paradigm" by Thomas Starzl.

The best and unique feature of the book is the sociological comparison of organ resources from Canadian, American and European perspectives. This should be compulsory reading for all those involved in Health Care Organization - no matter where we come from the result is the same: too few organs are available for transplantation.

This is an excellent text, representing the current state of the art in transplantation, that should be present in all anesthesia and transplant libraries.

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