We're getting ready to go down for a treatment. Here is an update about what has happened over the past 24 hours:
1. The ultrasound of the transplanted kidney that they completed last night after the surgery was not favorable. The Surgeon completed a second surgery around 1:00 am. He reopened the incisions to double check that the kidney was "hooked in" correctly. Everything appeared to be connected correctly, but blood flow was still a problem.
2. Mark spent the night in ICU. They monitored his urine and blood throughout the night. His urine output is good. Analysis showed his creatinine has dropped-but not as much as expected for a successful transplant.
3. They sent Mark to nuclear medicine for a scan using a contrast this morning. We just received the results about an hour ago. The results show that the kidney is perfused. In other words, blood is flowing into the main arteries of the transplanted kidney. However, they are unsure how well blood is circulating to the smaller arteries. Please remember that this is slightly more positive than the last transplant. In March, each scan they did of the kidney showed no perfusion.
4. They did another biopsy of the transplanted kidney this afternoon. Results are indicating that this may be a case of humoral/antibody mediated rejection. From what I can tell from talking to the Transplant team, there are different types of rejection. Antibody mediated rejection is very difficult to predict and is also difficult to treat. The antibodies that signal an immune response are involved with this type of rejection. The anti rejection medications commonly used after transplants don't always help. What seems to be even more confusing to the Transplant Team is that antibody mediated rejection usually doesn't occur so quickly after transplantation. There are medications that have helped other patients, but the "time frame" was different. These patients appeared to have a successful transplant initially and then later had difficulty. Mark is starting out with difficulty. The Transplant Team is giving Mark the medications that have worked in the past, but they are unsure if it will be effective.
5. The Nephrologist just placed another central line Mark's his neck. We are waiting to go down for a type of treatment that cleanses the antibodies from Mark's blood.
In summary, the prognosis isn't exactly favorable. The Team isn't that hopeful that this will work. However, we have more hope than we did last time. PLEASE CONTINUE TO PRAY!!!!!!!!!!!!!!! They are giving us a window of one to two days to determine if this will work.
Please remember to lift up Justin and his family. His mom reports that he is nauseous and hasn't felt like eating. He is spending most of his time sleeping.