Here is the latest on Mark and Justin:
1. The scan that was completed on the transplanted kidney showed perfusion-poor perfusion-but perfusion none the less. This means that blood is flowing into the transplanted kidney, but it is questionable how well the blood is circulating throughout the kidney. The scan also indicated a slight improvement in kidney function compared to the scan that was completed after the surgery. Although the scan showed improvement, it did not indicate a substantial amount of improvement. In other words, the kidney is a little better than it was initially, but is still not working as well as the Transplant Team had hoped.
2. Mark's creatinine level has not decreased since our last blog. It has stayed essentially the same over the past three days. This is "neutral" news in the sense that we had wanted to see a continual decrease of creatinine, but we are glad that the creatinine isn't increasing. A continued decrease of creatinine would indicate better kidney function and would mean that the treatments were successful in combating the rejection. A significant increase would be a bad thing as it would indicate that the kidney function was worsening.
3. Mark is continuing to receive plasmapheresis and anti-rejection medications (IVIG, thymoglobin). Plasmapheresis is a treatment in which the plasma or watery part of Mark's blood is extracted and replaced with a cleansed protein which is then mixed back in Mark's blood and pumped back into his body. As I understand it, the thought process behind this treatment is that the type of rejection that Mark's body is demonstrating involves antibodies; antibodies are carried in the plasma of blood; extracting the plasma through plasmapheresis would remove the antibodies that are triggering the rejection of the graft (transplanted kidney). Plasmapheresis reminds you of dialysis in the sense that it requires a special machine that literally pumps out the patients blood, cleanses it, and then pumps it back in the patient's body. Mark is receiving plasmapheresis every other day. On the days when he doesn't receive plasmapheresis, he is taking strong anti-rejection medications. One of which is IVIG. IVIG kind of has the opposite effect of plasmapheresis as its purpose is to neutralize the antibodies that Mark's blood is carrying. So, plasmapheresis cannot be completed on the same day that Mark takes IVIG because it would remove the IVIG from his bloodstream. The combination of IVIG and plasmaphereis is common practice for treating humoral rejection. However, as noted in a previous blog, Mark has hyperacute humoral rejection. It happened very quickly. Usually, humoral rejection happens later. So, it is questionable whether or not this will work.
4. Justin is at home and doing well. He has been calling to check on Mark each day. He drove his car today-so he must be feeling well!
5. At this point, we are playing a waiting game. No one really knows what to expect. It is a matter of waiting to see if the treatments will be successful in saving the transplanted kidney. All we know right now is that the treatments will continue throughout the weekend. The Transplant Team will make a decision on Sunday or Monday about whether or not to continue the treatments or to discharge Mark.
We are continuing to pray for a miracle. At this point, it seems that it would truly be a miracle if the transplanted kidney started working as it should. We know that God is completely capable of making our dream of a successful transplant a reality. We just don't know if it is His will to do so. Please pray for us as we will need His strength to accept any outcome.