As we knew from the start, the process of transplant is highly complex and one learns to be patient and adaptable. After several days of testing, the transplant team has advised that we delay the transplant for 2-3 months over concern that John's heart function is outside of the required parameters. Specifically, we need to reduce the level of a heart enzyme called troponin, which is a biomarker of cardiac injury on a cellular level. In John's case, this injury is the result of the amyloid deposits that are making his heart muscle less elastic and therefore less efficient at pumping blood. They are recommending a new chemo combination, which in many patients reduces troponin levels after a few months. These drugs are taken orally and thankfully can be taken at home. John will be monitored every two weeks through a blood test, with all results going directly to the Mayo team. Though we were very disappointed at this news, it is not uncommon for patients to experience delays in the program due to unforeseen complications. At least two other guests here at the Transplant House are here for their third evaluation after having been delayed in similar circumstances. We know that staying focused in the face of an ever-changing challenge is key, and we are hopeful that the new drug regimen will give us good results.
In the meantime, John's screening chest x-ray showed he had a badly collapsed lung and a significant amount of fluid. The assumption is that when Cedars drained fluid from his pleural cavity a few weeks ago, they put a small hole in his lung. The good news is that they discovered it here at Mayo and the very excellent pulmonary team sprang into action. After four days in the hospital the hole has almost completely resolved on its own (without surgery) and the lung has expanded to normal size. John is breathing better and we are hoping that he will be released from the hospital within a few days. He will have at least two follow-up visits with the pulmonary team, as well as with the cardiology department.
So that's it in a nutshell! Thanks to everyone for staying in touch...we'll keep you posted on this week's events!
