Transplant Day +29

Luke was transferred to Methodist Hospital here in Houston Tuesday evening to begin treatment for veno occlusive disease (VOD) - yet another acronym for your medical vocabulary to impress friends and family   VOD is a condition in which the small veins in the liver are obstructed. It is a complication of high-dose chemotherapy given before a bone marrow transplant (BMT).  There is not definitive test for VOD.  Its presence is primarily symptomatic, marked by weight gain due to fluid retention, increased liver size, and raised levels of bilirubin in the blood.  Luke’s biopsy did show signs of occlusion.   

Methodist participated in an FDA clinical trial of a drug called Defibrotide.   Defibrotide was found to be effective in treating VOD but use of the drug is still in FDA in never-never land.  Because Methodist participated in the clinical trial they have access to the drug and FDA allows the compassionate use the drug.  Defibrotide works by dissolving clots, the problem is it can work too good and cause internal bleeding.  Defibrotide has been in use in Europe for a number of years, in fact we were told they give it to BMT patients prior to transplant to address the VOD issue.  

Luke was started on Defibrotide immediately upon arrival at Methodist.  The protocol is for the drug to be given for a minimum of 21 days so Luke may not see the Houston sky until February 1. 

Luke has been in a lot a pain due to the accumulation of fluid in his abdomen and swelling of the liver.  He is still being medicated heavily and at times is disoriented.  For clotting they are trying to keep platelets up.  They are also limiting his fluid intake.   They have drained Luke’s abdomen to relieve the pressure he is having.  Luke has not eaten anything since the last week and by draining his abdomen he is losing all the protein in the fluid which is not good.  Needless to say it is a balancing act.

Hated to leave the familiar surroundings of MDA but the docs at MDA were on top of the VOD issue and thought getting Luke on Defibrotide needed to be done.   

The guy needs a break!

Luck Feukemia!