Abstract
The number of solid organ transplants performed in the United States continues to increase annually as does survival after transplant. These unique patients are increasingly likely to present to arthroplasty surgeons for elective hip or knee replacement secondary to a vascular necrosis from chronic immunosuppression, or even age-related development of osteoarthritis. Transplant recipients have a well-documented increased risk of complications but also excellent pain relief and dramatic improvement in quality of life. A multidisciplinary approach with the assistance of the medical transplant services for risk stratification and perioperative medical optimization is necessary. Prior solid organ transplant is not a contraindication to surgery; however, it is the responsibility of the surgeon to educate patients about the relative risks and benefits of prior to surgery.