الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Background: Reperfusion injury is responsible for haemodynamic instability and postoperative complications (POC) during and after ALDLT. Ketamine has haemodynamic and anti-inflammatory effects.
Aim: is to assess immediate and late effects of a subanaesthetic dose of ketamine hydrochloride (K) when administered prior reperfusion on tumor necrosis factor (TNFα) and Interleukin 6 (IL6) serum inflammatory markers. Secondarily the impact on haemodynamics and POC.
Methods: Local Ethical Committee approval and PACTR201512001367808, (2016-2018), 43 recipients (one excluded).. randomized into K gp (n=21) Ketamine IV bolus (0.5-0.7mg/kg) and Controls C gp (n=21) received (5 ml saline), both prior to reperfusion. Anaesthesia depth, haemodynamics (MAP, Cardiac output CO, Systemic Vascular Resistance (SVR) Electrocardiometry (Osypka Germany) were monitored. pH, bicarbonates HCO3, AST, ALT measured. Times:T1: base line, T2: 5 min post reperfusion (for haemodynamics), T3: 1 h post reperfusion, T4: 24 h. TNFα, IL6 measured at T1, T3 and T4). Clavien-Dindo Classifcation (CDC) score for POC. Anaesthesist were blinded.
Results: Data median [IQ]. Comparable (age, sex, MELD) p>0.05. Less patients were in need for norepinephrine and epinephrine in K vs. C during reperfusion (T2) . MAP and SVR were higher at T2 K vs. C, p=0.01 but 1 hour later (T3, T4) MAP and SVR were comparable, P=0.5 and P=0.1. T1-4 for pH, HCO3, ALT, AST values in K vs C were similar p=0.45. TNFα at base line (T1) were comparable (p>0.05), but in 1h (T3) and 24 h (T4) the TNFα was significantly reduced in K vs. C gp. IL6 values was only reduced after 24h
Summary
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Conclusions: A reduction in TNFα and IL6 serum levels was observed in 24 h following the Ketamine Hydrochloride administration with an immediate haemodynamic supportive effect was reported during the few minutes following the reperfusion. (T4). Reduced CDC (II, IIIb, IV) score in K vs. C (38, 9.5, 19 % vs. Controls 42, 23, 43%, p>0.05) respectively.