Biopsy News

Well I sure didn't think I'd be writing this post tonight; at least not this soon after transplant and especially since Stephen has been doing so wonderfully the past couple of weeks. We were admitted last night at CHOP and they repeated his blood work this morning to double check that his creatinine level was as high as it had been on Monday. Turns out, his creatinine fell back down. So we spent the morning thinking we would go home this evening after Stephen received an IV fusion of neupogen; a drug that helps white blood cell production. But later today, we got some not-so-great news from the transplant docs. 

At one month post-transplant, the protocol tells the doctors to run some tests to check to see which antibodies the recipient has formed and they compare them to the donors antibodies and the antibodies the recipient had before transplant. Stephen's results showed that his immune system is now producing lots and lots of antibodies that he did not have prior to transplant. Basically, despite his immune system being suppressed, it's working on overdrive, trying to fight off the new kidney. The kidney is functioning perfectly; his BUN and creatinine are perfect, but Stephen's immune system is working in a way they couldn't have predicted it to. The bottom line is that he is in the very beginning stages of rejection. More specifically, what is called AMR rejection. It's so complex, and I'm only starting to try to understand it. But what I do know is that they are ways the doctors can fight off the rejection and reverse it.

So later this week (we think), hopefully on Friday, they will remove the stint and while Stephen is under anesthesia, they will biopsy the kidney to determine the extent of the rejection. Hopefully they've caught it soon enough that it can be managed with medication. If not, he will need to undergo plasmapheresis (stuff that is still over my head for the time being). However, we know, once again, we are the right place, and we have the utmost confidence that the doctors here at CHOP can get this under control. It was very unexpected news, but we're really hopeful and trying to remain super positive that this will come out in our favor.

Unfortunately, right now we don't yet know when things will happen or when we'll go home (could be tomorrow morning or could be next week), but we're hoping to be discharged in the morning following labs and then will return on Friday for the surgery. 

On the flip side, at least Stephen has been having a good time here at the hospital this time (I thought he was going to freak when we got here, but he immediately started playing ball)! He was bouncing off the walls today, running up and down the halls, and was able to get for a few walks.