General Anesthesia for a Child With Methylmalonic Acidemia Undergoing Oral Care and Dental Treatment Before Kidney Transplantation.

Methylmalonic acidemia (MMA) is an autosomal recessive metabolic disorder of organic acids that causes various symptoms attributed to the accumulation of methylmalonic acids. We report the general anesthetic management of a 7-year-old girl with MMA who underwent periodontal treatment prior to kidney transplantation. One of our anesthetic goals was to maintain appropriate metabolism perioperatively, so we minimized her fasting time as short as possible and administered specially adjusted milk with simple carbohydrates preoperatively to reduce catabolism and promote anabolism.