Thursday, November 9, 2023

Well that came out of left field

Just when we thought we had a fairly good handle on things, and Becky was stable, and all we had to do was stay strong enough for surgery, here comes a curve ball. Can you throw a curve ball from left field? Probably. But I digress.

The kidney doctor stopped by this morning to let us know that Becky was being evaluated for a potential kidney transplant. Obviously since the liver and kidneys are so interdependent and she's on dialysis, we knew they were monitoring her kidney numbers. However, there hasn't been any mention of acute kidney damage or failure. And that's still the case–no acute failure/damage. On the other hand, it's not uncommon for the kidneys to be affected by the liver failure and for dialysis to be required after the liver transplant if the kidneys don't recover.

In Becky's case, a new liver doctor was in charge of her case this week and he dug into her history as he was coming up to speed. He found evidence that the kidney GFR numbers started to trend in the wrong direction in August, specifically August 14th. In the opinion of both teams it now makes sense to replace both organs at the same time rather than take the (increased) risk of a second transplant later. To be clear, her kidneys haven't failed yet, and she's on the CRRT dialysis to keep that from happening. But since she was trending in the wrong direction before, it makes sense to do a dual transplant now rather than take the risk of her kidneys not recovering after the liver transplant and having to go through dialysis and a second transplant later.

The good news is that somebody noticed this and has recommended this as a new course of action. We think it makes sense to reduce the risk of dialysis and a second transplant. The down side is that she doesn't qualify for the kidney transplant until her GFR numbers trend in the wrong direction for at least 90 days. That means we won’t be on the kidney transplant list until next Tuesday (the 14th of November) and, therefor, Becky is now officially listed as inactive on the liver transplant list. So as long Becky remains stable we'll be here in our new home away from home and my remote office, a.k.a. the UT Southwestern Medical Center ICU, until at least next Tuesday when she becomes active on both lists.

If anybody wants to come visit this weekend, I’m in a room with a trundle bed so I can easily accommodate a couple extra guests.

Please continue the prayers. They've gotten us this far!

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