Transplant Surgery Updates!

6:45pm update:
Job is out of surgery and is going to be settling into his CICU room soon, at which point we will get to see him.

The surgeon was very pleased with how everything went.

Job has a fever, which is likely a reaction to a medication or steroid used, and his heart rate is very high. Fevers always increase heart rate, as does the rough transition the right ventricle always has after a heart transplant. These issues ought to resolve well with medication and time.

The first 24-48 hours post-op tend to be intense, so that's what we're anticipating. Rejection doesn't tend to be quite as much an issue these first days because his immune system is so suppressed right now and because his body is fighting so hard to get used to pumping this new circulation. We're probably primarily looking at "standard" open heart surgery recovery issues through tonight and tomorrow.

2:40pm update:
The old heart is out and the new heart is in. The surgeons are stitching up the connections from the new heart and pulmonary arteries to Job's aorta and the stubs of his original pulmonary arteries now. The new heart, Job's NEW HEART, is profusing well and pumping with assistance of bypass. He's bleeding a great deal, which was expected, but now needs stopped. Once the bleeding is under control then they will begin to wean off bypass and then, if all looks well, close his chest, and then take him to the cardiac ICU (CICU).

We're hopeful we might get to see him around 7pm tonight. He'll be on the ventilator and have the standard wires and tubes that we are familiar with after cardiac surgeries. He'll be very well sedated as well.

So far every thing has gone well, even if it's taken extra time to accomplish.

11:00am update:
The procurement team retrieved the donor heart and is on their way back to Seattle Children's Hospital.

Job is doing well. They started his chest dissection, which will be about a two hour process. They think it's possible the donor heart will be here at the hospital and into Job around 1-2pm and will update us then.

9:45am update:
There has been a delay at the donor's operating room. They can't tell us what the delay is or how long it will be.

Job is anesthetized and waiting peacefully for word on the donor heart viability.

9:00am update:
So the optimistic timeline of today is:
-6:00am met with surgeon, signed consent
-6:15am meet with anesthesiology team, safety check; wheel Job to the OR
-6:30-8:30am put him under anesthesia, get him comfortable, put in PICC line
-8:30-9am the donor organ retrieval team opens the donor chest and lays eyes on the (artificially) beating donor heart and then gives the official "go ahead" *if* the heart is viable
-9:00-11am chest dissection (he has so much scar tissue that it takes a long time!); Job goes on the heart lung machine, which pumps his blood for him
-11-1pm the new heart arrives to the SCH OR and Job's broken heart is removed and then replaced
-1-2pm surgical connection and reconstruction of his pulmonary arteries and aorta; new heart starts beating
-2-4pm watch new heart and stop bleeding from suture sites
-4-5pm recovery, assessment
-6pm taken to cardiac ICU

6:50am update:
Job just went into the OR. We should receive confirmation regarding the viability of the donor heart by 8:30 or 9 am.

Further updates throughout the day will be made on this post!