Tyler’s fever remained high this morning, and a new concern arose. Tyler’s bilirubin levels have steadily increased over the past few days. Post-transplant, this is usually an indication of Veno-Occlusive Disease (VOD). VOD is when the small veins leading to the liver are blocked and is one of the most frequently encountered serious complications after BMT. It’s caused by Busulfan, one of the chemos in the BMT preparative treatment.
Tyler’s only sign so far that he may be developing VOD is his high bilirubin levels. His doctors are quite sure that none of the other possible culprits of high bilirubins are at play. They are monitoring Tyler very closely for an enlarged liver and ascites by weighing him and measuring his girth twice a day. They’re also significantly reducing his fluids and saline. Tyler had an ultrasound of his liver today, which looked good. The encouraging thing is that if he does develop the other symptoms of VOD, they will catch it very early and he will be eligible for a study drug that’s been very successful with treating VOD when caught early.
Unfortunately, now Tyler cannot go on TPN, which would put additional stress on the liver. So until his nausea resolves, he won’t get any nutrition and only limited fluids. The hope is that with these preventative measures, his liver will heal on its own.
God is able to do far more than we would ever dare to ask or even dream of – infinitely beyond our highest prayers, desires, thoughts or hopes! Ephesians 3:20