Due to the recent decision by UCSD not to list me for transplant, we've been aggressively pursuing second opinions at other transplant centers. We are thankful for some inside connections at some different facilities that have expedited the process of getting in for all these appointments.

This week we met with UCSDs interventional radiology about the procedure to open up my portal vein, it would be a portal vein recanulation with TIPS procedure. They are willing to attempt this, it’s about a 4-5 hour procedure with 1-3 nights in the hospital recovery. It’s essential a 50/50 chance of whether or not it would be successful since it’s a chronic occlusion. We are planning to speak with these other transplant teams to help make a decision if attempting this procedure is worth it to help to improve transplant outcomes.

Other upcoming appointments:

March 18th: Meeting with my advanced endoscopist at UCSD to discuss her view on viability of future ERCPs and how long she thinks we can keep stenting (mine are much, much more complicated than the typical ERCP). We also want to discuss cancer risks related to the dominant stricture. Her input feels helpful for us to make a decision on timing of transplant.

March 19th - 21st: We are flying out to Intermountain Healthcare in Salt Lake to get a full transplant work up, which will include meeting with the hepatologist, dietician, surgeon, social worker, and transplant coordinator over three days. A few of the doctors there have already reviewed my imaging and feel optimistic about transplant at their facility. 

April 1st: We are meeting with USC's transplant team (hepatologist, surgeon, ect.) for another full transplant work up. We felt a third opinion was crucial for understanding the risks of the anatomical work arounds the surgeons will have to conduct during transplant because of the portal vein thrombus. USC also has one of the top living donor programs, which could be helpful in case that becomes an option again.

April 11: Tentatively scheduled to replace the current stents with another ERCP procedure. My labs are still good right now and my doctor wants to wait as long as possible to switch them out since it has been such a difficult procedure historically. This date would be pushing my max time for the stents.

It'll be a busy next few weeks, so we appreciate prayers for logistics to be smooth, wisdom, emotional endurance, and fun sprinkled in between. 

David