2020 年 70 巻 2-4 号 p. 156-162
In kidney transplantation, stable hemodynamics is essential to preserve graft function. We used ketamine as an anesthetic because of its sympathomimetic properties. On the other hand, ketamine has several adverse effects, such as prolonged emergence from anesthesia or psychological reactions. Altered ketamine pharmacokinetics was previously reported in rabbits with renal insufficiency, but no study has examined human living kidney transplantation, which has the potential to cause renal insufficiency in the donor and recipient. Therefore, we evaluated ketamine pharmacokinetics in the donor and recipient of living kidney transplantation in various situation including ABO blood type-compatible and -incompatible transplantation.
Materials and Methods: We examined the ketamine pharmacokinetics in donors（n=8）, and ABO blood type
-compatible（n=8）and -incompatible（n=8）recipients of living kidney transplantation. We also measured the estimated glomerular filtration ratio（eGFR）, blood urea nitrogen（BUN）, and serum creatinine in these patients.
Results: The time course of changes in the ketamine level after stopping ketamine administration did not differ between the donors and recipients. We also found that the eGFR in recipients gradually improved 48 h after the kidney transplantation. No patient developed ketamine-related adverse effects or allograft rejection.
Conclusion: We conclude that ketamine can be safely applied as an adjuvant with intravenous anesthesia during ABO blood type-compatible and -incompatible living kidney transplantation.
