Here's the latest new information...
First, my BK test results are NOT back yet due to the whole Chinese/Corona/Wuhan/CCP virus testing. My test had to be sent to a secondary lab, and the results will not be known until tomorrow.
Meanwhile, the Transplant Clinic doctors ordered a new and experimental blood test called AlloSure to be drawn ASAP. (I am placing info on this test at the bottom of this post) I received a special kit this morning and will take it to the lab today for the blood draw. The lab will use the kit (whatever it is) and send it back to the originating company for analysis. The results, which apparently show the level of rejection in a kidney, should be available by Monday Morning.
Assuming the BK results are negative, I will start a course of 60 mg Prednisone for each of three consecutive days, then do my next full lab draw on Tuesday morning.
Now, depending on the results of the labs and the Allosure, one of two immediate things will happen....
1) The kidney is inflamed, and needs to be calmed down. In this case, I will possibly continue with the Prednisone increase, while simultaneously reducing my daily intake of Myfortic. Labs will be drawn every two weeks for analysis.
2) The tests all show that I am in rejection, and I will immediately be ordered for a renal biopsy, followed by an in-hospital course of Plasmapheresis. If I have to have this done, I will explain what it is and how it is done. For now, a very short explanation is the any antibodies that I carry are filtered out via a dialysis-like machine. The treatment takes three days.
Also, during this time I would get all the paperwork redone for placement on the Transplant List, so that if all efforts to keep the kidney fail, I am already accumulating time of the list.
Lastly, because of my weight fluctuations on the Torsemide vs non-Torsemide day, and the overall gains of weight despite the diuretic, I am to take the Torsemide every single day--for now--and be sure that I drink at least three full liters of water every day. The daily intake of the Torsemide could change once we know all results on Tuesday.
So again, as I stated on my last post, next week is pivotal in how things will be moving forward.
I will keep you updated.
Until then...
Keep yourselves safe from the virus, and stay healthy and strong despite this crisis.
Please, once again keep me in your prayers as I head into this uncertain time.
Good Health to All!
ScottW
Test Name
AlloSure® Donor-Derived Cell-Free DNA Test CPT code: 81479
Intended Use
The AlloSure test is intended to
assess the probability of allograft rejection in kidney transplant recipients
with clinical suspicion of rejection and to inform clinical decision-making
about the necessity of renal biopsy in such patients at least two weeks
post-transplant in conjunction with standard clinical assessment.
Indications for Use
AlloSure is indicated for use in
renal transplant patients who are 18 years of age or older and at least 2 weeks
(14 days) post-transplant. Clinical validity of the AlloSure test was
established in single-kidney transplant recipients who were 18 years of age or
older and at least two weeks post-transplant.
Summary and Explanation of the Test
(Principle of the Test)
The AlloSure test is a
clinical-grade, targeted, next generation sequencing (NGS) assay that measures
single-nucleotide polymorphisms (SNPs) to accurately quantify donor-derived
cell-free DNA (dd-cfDNA) in renal transplant recipients without separate
genotyping of either the donor or the recipient. The assay quantifies the
fraction of dd-cfDNA in both unrelated and related donor-recipient pairs.
Blood is collected from the
patient, packaged, and shipped at ambient temperature to CareDx for testing.
dd-cfDNA is measured via targeted amplification and sequencing of a set of
carefully selected and validated SNPs. The AlloSure bioinformatics software
calculates the percent dd-cfDNA in the sample tested and applies the QC cut-off
values. Most AlloSure test results are reported to the ordering physician
within 3 days from blood specimen collection.
**For more information, please
visit www.caredx.com/allosure
*NOTE: the above
address for AlloSure is for the Kidney ONLY; though there are links for other
information.
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