Results are in ..
The good news is the lung tissue that was biopsied was Negative for acute cellular rejection. Yay!
We know from the CT scans that there is some chronic rejection, but that is to be expected at this point post transplant.
The not so great news is the lavage showed increased (25%) lipid laden macrophages. This would most likely be a result of aspirating. Riley does not drink like the rest of us, for this reason, however for quality of life reasons he does take ‘sips’ on occasion. This may be the cause of the increased lipid laden macrophages. That being said Riley still struggles with eating. He pockets food in his cheek, and can sometimes take 45 minutes to clear his mouth. So it’s also possible that he’s aspirating some of the food. Another possible cause could be reflux. Most of Riley’s diet is through his gtube. Riley did have a Thal fundoplication after transplant to try and prevent refluxing, but a Thal is a partial fundoplication unlike the Nissen. Dr Nance was unable to do a Nissen because of Riley’s heterotaxy. So that would leave some room for reflux. Right now we just can’t be sure.
The other thing that was discovered from the bronch is low grade lymphocytic bronchiolitis. They aren’t overly concerned. It is believed to be caused either by the recent pneumonia or aspirating.
The plan is to head back to GI and see Dr Ryan and to also see Dr Ruiz in ENT. Dr Ruiz is newer to CHOP and specializes in swallowing. Riley will also have another swallow study done to see if he’s aspirating and does he also aspirate some food when he eats.
Everything in Riley’s world is a balancing act. Trying to do everything to give him the longest life possible .. while trying to give him quality of life now.
Happy Friday to you ALL and as Always
Thank you for being on this Journey with Riley and our family!