&NA;Anesthesiologists will be caring for more transplant recipients in the foreseeable future. This is because of improvements in transplantation techniques and in the management of diabetes and renal disease. The cardiovascular comorbidity associated with both renal and pancreas recipients is truly a common denominator in the assessment and perioperative care of these patients. This review briefly describes new findings in the pathophysiology of the renal and pancreas transplant recipient population. It also covers several topics germane to anesthesiologists including preoperative assessment and concerns, intraoperative management and outcomes following transplantation.