This chapter discusses about the management of adult renal transplant patients in emergency department, PACU, MICU, SICU, and CCU, where focus on issues such as patient selection, nature of the surgery, and adverse consequences of immunosuppression should be given. Immediate PACU postoperative considerations or limiting factors include persistent respiratory compromise, respiratory alkalosis, hemodynamic instability, cardiovascular problems, severe hypertension, and uncontrolled hyperglycemia. Delayed metabolism of anesthetics and sedatives in these patients with renal insufficiency may result in prolonged respiratory and cognitive depression. Noninvasive positive pressure ventilation in extubated patients may be required before transition to supplemental oxygen either by mask or nasal cannula. Ultrafiltration is an additional option but requirement for continuous IV administration of antihypertensive agents is best accomplished in the critical care setting. Postoperative considerations the ICU include hemorrhage, respiratory failure, hypotension, renal failure, infections, and metabolic abnormalities.