Perioperative anesthesia management is a major challenge for patients with multiple organ dysfunction undergoing surgery. Comprehensive preoperative assessment and intraoperative anesthesia management are of great significance to improve the safety of anesthesia operation and postoperative rehabilitation. The patient suffered from severe novel coronavirus infection after kidney transplantation, and successively developed kidney graft failure, cardiac insufficiency, pulmonary hypertension, respiratory failure, sepsis, and renal anemia. During the operation, the patient completed the operation smoothly through circulation management, cardiac function support, volume management, protective ventilation strategy, as well as anti-inflammation, anti-stress, heat preservation and other comprehensive treatments.