In practice, it immediately becomes a 6/6 flying lifelink the moment youre above 30 life, which in Commander means its usually online the second it hits the battlefield
Orim's Chant takes it a step further by also preventing one targeted player from attacking, which gives you both combo protection and breathing room
I built around the ninjutsu and other self-bouncers here - But you could make this flickering too instead
Karlov of the Ghost Council A really inexpensive commander with a removal ability, Karlov of the Ghost Council is decent Orzhov lifegain commander who lets you run your Soul Sisters with the Sanguine Bond + Exquisite Blood nonsense you love
That's right--you essentially turn one unlucky opponent into your personal puppet, dictating their resources to your advantage
Once demand has been sated, Ketramoses price will likely see a readjustment.