Transplant Day + 24

No significant change overnight - the things they are tracking appear have have either stabilized or gone down. The thinking is the accumulated effect of chemo and medicines Luke is receiving is impacting his liver and causing the small vessels in the liver to occlude and that is impairing blood flow. He is retaining fluids and his abdomen became is very distended. Luke has a lot of abdominal pain and getting comfortable is difficult. Over night they took him off or reduced the dosage of meds that may affect the liver. They also reduced Luke's fluid intake and he has started to pee. Overnight he did not have weight gain which is positive. His liver and kidney functions were trending in the wrong direction yesterday but overnight it looks like they stabilized or dropped a little. He is getting an ultrasound to see how much fluid is on his abdomen. Depending on what the ultrasound shows they may pull fluid from his abdomen. Transplant brought in a consult on the liver. There was some discussion around giving Luke a medicine to dissolve clots in his liver. Before they do that he will probably get a liver biopsy to confirm whether the small vessels are clotting. The treatment to dissolve clots was just recently approved by FDA. If the decision is for him to receive the treatment he will have it done ate Methodist as MDA is currently not approved to administer. Luke got more platelets this morning. They are holding up on giving bed blood to limit his fluid intake. Temperature has not a problem overnight but they continue to run blood cultures. Experienceing some nausea.