Since Murray, et al performed the first successful human kidney transplantaion in 1954, the renal allograft has become a well documented and accepted method for the treatment of the patient in the final stage of renal failure. However from the anesthetist's point ef view, most patients with renal failure are poor risk due to such factors as hypertension, anemia, hyperkalemia, acidosis, bleeding tendency, hyper-or hypovolemia, although these factors may be controlled to a great extent by hemodialysis and antihypertensive drugs. Therefore every anesthetist should keep in mind the risk factors for anesthetic management of the patient in renal failure. Fifty-six cases of renal allograft from living donors were performed under general anesthesia at Severance Hospital, Seoul, Korea, between April 1979 and August 1981. We report our experiences with anesthetic management of these cases along with precautions and give references.