Living donor transplantation presents unique anesthetic challenges, requiring the surgical intervention on a healthy individual for the benefit of another. The anesthesiologist must balance protecting the donor from preventable morbidity while optimizing conditions for successful organ procurement. This chapter addresses comprehensive anesthetic management across kidney, liver, and lung donations, emphasizing the distinct considerations for each organ system. Preoperative assessment extends beyond standard surgical screening to include extensive cardiovascular, pulmonary, and renal evaluations, as well as psychological factors that influence perioperative outcomes. Anesthetic management varies significantly based on the target organ and surgical approach, with kidney donation representing the most common procedure, and liver donation, the most complex. Key principles include goal-directed fluid therapy, organ-specific hemodynamic targets, careful coagulation monitoring, and coordination between surgical teams. This chapter provides evidence-based protocols for intraoperative management, addressing monitoring requirements, pharmacological considerations, and organ protection strategies essential for ensuring donor safety while maximizing transplant success.