Transplant -13 (Thursday)

Today Jackie had one of two preliminary Rituxan treatments. It required most of the morning. She tolerates these treatments reasonably well. Her next treatment is scheduled for next Wednesday. At that point the transplant process begins in earnest.

We spent about 2 hours this afternoon with one of the transplant nurses. I guess you could call it an indoctrination session. She explained the general routine and covered how she felt Jackie might progress (or not). When she learned that Jackie's donor was a 10 point molecular match she seemed very relieved. She said this was very unusual and she felt Jackie would make better progress. She said that they do transplants with as little as a 4 point match. She stated those patients usually had a difficult time.

I think the biggest point she tried to make was just how drained and tired Jackie would feel during the transplant. It seems there will be a 3-4 week process when Jackie will not want to get out of bed. She impressed upon on us the necessity of being active so as to avoid pneumonia. Jackie will be treated as an outpatient. She will go inpatient only when she faces a complication or is too sick to live at the apartment. The center here at the Mayo is unique in that respect. You can go from inpatient to outpatient status simply by showing up at the transplant desk and saying, "I want in". The process is very transparent.

We did learn a couple of things today we didn't know (or we had forgotten). On the actual day of the transplant Jackie will get a preliminary 4 hour course of IV fluids through her surgically implanted Hickman port, then the transplant, and then another 4 hours of IV fluids. The do this to protect her kidneys by constant flushing.

As a note of interest Jackie's blood type will change after the transplant to match that of the donors (if his type is different than what she now has). When you realize that your blood type - the one you were born with, will completely change for the rest of your life it kind of crystallizes just how life altering a transplant will be!