[Sevoflurane anesthesia in a patient following renal transplantation]

A 29-year-old male after renal transplantation with aseptic necrosis of the head of the left femur was anesthetized with sevoflurane-nitrous oxide-oxygen for replacement surgery. Anesthesia was induced with N2O 4 l.min-1, O2 2 l.min-1, plus sevoflurane and maintained with N2O4 l.min-1, O2 2 l.min-1 and sevoflurane. Sevoflurane concentrations ranged from 1% to 4%. The serum inorganic fluoride showed the peak level of 38.4 microM.l-1 about 60 minutes after discontinuation of sevoflurane a decrease in serum inorganic fluoride was delayed. Urinary N-acetyl-beta-D-glucosaminidase (NAG), gamma-glutamyl transpeptidase (gamma-GTP) and beta 2-microglobulin (beta 2-m) increased over five postoperative days. NAG and gamma-GTP returned to the preanesthetic level on the 6th postoperative day, but beta 2-m higher than the preanesthetic level lasted for 14 postoperative days. In conclusion, sevoflurane brought about little effect on the transplanted kidney in this patient.