Anything is possible
heart transplant, inspirational story, organ transplant, motivational story, kidney transplant
"After 2 months of living with antibody mediated rejection & taking oral chemo meds.. it's time to find out if this ticker still has 'rejection' or not and what the next step is"!
Today is the waiting game day. Yesterday Lauren and I went to Brigham & Women's Hospital in Boston Ma. for her heart biopsy, clinic appointment and echo.
My daughter Lauren, had her heart and kidney transplant on May 17, 2018
During the biopsies, they take a tiny piece of the heart muscle and look for signs of inflammation or rejection. This is the only way doctors can tell early on if your body is rejecting your donor heart.
After you have a biopsy, you will receive your results 24 hours later. You always pray for no rejection, but there are times when that is not the results you receive. Lauren's biopsy have all came back a 0, no rejection until last October . There are different stages of rejection. Lauren's came back as an AMR, antibody-mediated rejection. First time with a AMR rejection. After everything we went through over the past 5 years, I thought we knew mostly everything about transplantation and rejection. Totally wrong. I know as much as I needed to know, we never heard of AMR. So it was back to studying. I wanted to share some of the information I found. Treatment right now is adding a medication called METHOTREXATE.
***Methotrexate tablets are used alone or together with other medicines to treat several types of cancer such as breast, head and neck, lung, blood, bone, lymph node, uterus cancers, and severe rheumatoid arthritis.
****Methotrexate oral solution is used to treat acute lymphoblastic leukemia (ALL) in children, and help manage polyarticular juvenile idiopathic arthritis (pJIA) in children who had other treatments that did not work well.
*****Methotrexate belongs to the group of medicines known as antineoplastics (cancer medicines). It blocks an enzyme that is needed by cells to live. This interferes with the growth of cancer cells, which are eventually destroyed by the body.
Below is a grading of biopsy rejections:
**Grading rejection The pathologist, the medical Doctor who reviews the tissue slide for the diagnosis of rejection rates the presence and severity of rejection based in the International Society and Heart Transplant scale.
Antibody-mediated rejection (AMR)
Rejection refers to the organ recipient's immune system recognizing a transplanted organ as foreign and mounting a response to it via cellular and/or humoral (antibody-mediated) mechanisms. Routine endomyocardial biopsy remains the criterion standard for monitoring for such rejection. This process involves sampling of the right ventricle using a bioptome, and a pathologist evaluating the tissue. The concept of rejection is not unique to cardiac allograft transplantation and, to a varying extent, occurs in all forms of solid organ transplantation
Cardiac transplant rejection manifests in 1 or more of the following 3 ways: acute cell-mediated rejection, antibody-mediated rejection (AMR), and allograft vasculopathy.
Since Lauren has been showing AMR rejection, the doctors have scheduled a special blood test that will be done during the biopsy. The tube for this blood test needs to be personally handed to the doctor in the procedure room. It will then be flown to UCLA for examination. There are only a few institutions in the country that preforms this special test. This test was ordered by Lauren's kidney transplant team.
If we receive the news today that Lauren is still in AMR rejection, the team of doctors will discuss Lauren's case Wednesday during their transplant team meeting to put together a plan. They have mentioned the next step could be Plasmapheresis, which would be a hospital stay, possibly a week.
What is plasmapheresis? Centrifugation spins the blood for plasmapheresis.Pheresis, or apheresis, describes any process that removes the blood, filters and retains elements of it, then returns the blood to the body. Platelets, red blood cells, white blood cells, or plasma may be separated.
The procedure is performed using a machine that removes small amounts of blood at a time.
There are two ways to separate the components of blood:
So much information.......
We will probably hear back from the doctor's later this afternoon with results. Pray, pray, pray for
Strength in a Heartbeat, Diary of a Heart Transplant
Read our personal journey on the heart transplant list