Update and What is MELD, Anyway?

Dad heard from Cleveland today, but in order to understand the encouraging news he got I think I should say a few words about MELD (Model for End-stage Liver Disease).

What is a MELD score? Briefly, it is the result of three blood tests that are put into a formula to generate a number - the MELD score. This gives the doctors an idea of just how sick a patient is. For those of you who want a more in-depth description, here is a link to the Cleveland Clinic website: http://my.clevelandclinic.org/transplant/services/liver/MELD.aspx

The MELD score, however, doesn't always take into account other important medical conditions. As in Dad's case, it doesn't consider his heart valve problem. So the transplant doctors look at each individual case. If there are additional circumstances to be considered they can request additional points be added to a patient's MELD score. If I understand the process correctly, this must be approved by a committee of transplant doctors within the region that the transplant hospital operates.

The call that Dad received today from his coordinator was to inform him that the doctor had placed a request to add additional points to his MELD score. If this is approved, his MELD score would be high enough that he would be more likely to receive a call sooner rather than later.

Visit with a Liver Surgeon

Yesterday we once again travelled to Cleveland. We had an appointment with a liver surgeon. Since it was the decision of the experts to perform both the heart valve surgery and the liver transplant at the same time the transplant committee wanted to be sure that we understood the increased risk involved. We met with a liver surgeon that we all like very well. She is encouraging and has a sense of humor - which is needed when Dad is your patient! She "gets" his humor.

As we were preparing to leave the coordinator informed us that Dad had been officially listed on the transplant list. The coordinator gave Dad and Mom a notebook full of information to help them be ready for "the call" and everything that happens after that. The length of the waiting time depends on many factors and no one can tell us how long it will be. We may even get a call and end up being sent back home. Everyone we have spoken with emphasizes that they will not do anything if they don't feel confident that it will be successful.

Thanks for your prayers!

On the List

Dad and Mom just received a call from their transplant coordinator. The committee decided to put Dad on the transplant list. Now we begin the waiting phase. We will be traveling to Cleveland again next week, probably Wednesday, to meet again with a liver surgeon.

We really appreciate all the calls and emails telling us of your prayers!

Home From Cleveland

We met with the heart surgeon today. He agrees it would be best to replace the heart valve and do the liver transplant in the same surgery. 

Dad's coordinator said that his case will be reviewed on Friday. She doesn't see any reason he would not be put on the list. It will take about a week before he will actually be listed. 

The cardiology team and the liver team will meet on the following Wednesday to discuss Dad's case as well. 

Once he is officially on the list the waiting begins. We will try to keep him as active and healthy as we can until he gets the call to go to Cleveland to have his surgery.

See for Yourself

I thought you all might like to see how Dad is doing for yourself. This was taken a

few weeks ago when Bill and Amanda were up for Father's Day. He is being his usual goofy self with the granddaughters.

Appointment with Heart Surgeon

Dad heard from Cleveland today. The heart surgeon needs to see him before he will make a recommendation. Dad is scheduled to go to Cleveland on Wednesday morning. We will probably leave Tuesday evening since his appointment is early Wednesday. We believe this is the final piece to be added so that the transplant evaluation can go before the committee.

Waiting Again. . .

We got back home from Cleveland this evening about 8:30. Everyone who saw Dad seemed to be of the opinion that both surgeries(heart repair and liver) would need to be done at the same time. We are now back to waiting for the transplant committee to meet and make their recommendation. They should discuss Dad's case next Friday if all goes as planned.

We got to meet several transplant patients and their family members while we were there. It is amazing to see what is being done and how quickly some of these patients get to go home and return to a normal life!

Back In Cleveland

We made an unexpected visit back to Cleveland Clinic. Dad was having some breathing problems related to some side effects from his heart cath. His primary care doc sent him up here. We have seen doctors from both the liver and internal medicine staff. We expect to see the cardiology surgeon tomorrow. The plans for the heart surgery may have changed. We will find out when we talk with him. We expect to be heading back to Findlay tomorrow. More updates when we know more.