He is scheduled for a biopsy tomorrow as second case (so around 11am).
In the biopsy they'll go in with a catheter through his neck vein and snip off pieces of tissue from his right ventricle, which should go to pathology by afternoon. We find out whether or not he is in rejection (and what kind of rejection) tomorrow evening or Thursday morning.
Rejection is treatable but certainly this is hard news. Frankly, we don't even know enough about transplant yet to have perspective on all of this.
He's not terribly upset when he's eating/drinking and not being poked.
More details:
Tacro is Job's primary immunosuppressant medication and his "level" of it is supposed to be between 10-12. It was a 6 last week so we upped his dose and drew labs again yesterday morning. Those came back today at a 4. So we upped his med but his level still dropped.
Also yesterday we noticed that his face was pretty swollen and puffy and his stomach was huge and firm. The team had us give extra meds last night and he did look less puffy this morning, but we were already on high alert when his Tacro level came back so low today.
So we packed our bags and drove north. He's had his echo and EKG and x-ray and a whole team of people assessing him.
He has some fluid in his left lung but the main issue of concern (other than his inadequate Tacro levels) is that his mitral valve and tricuspid valve reguritation is moderate after two echos with no regurge (one each week).
He could just have excess fluid in which case we'll up his diruetics and go home. But the head of the transplant team told us he'd give that about a 20% chance.
Or we'll stay 3-7+ days and treat for rejection. And reset the clock on his intensive course of immunosuppressants and steroids (when we were already on week 5 of 12).
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