During all of the hours in which Patty has been awake and alert today, she has been plagued by a headache. Thankfully, she has been able to sleep for much of the time.
While I was doing some research today into the use of rituximab (Rituxan) to reduce panel reactive antibodies (PRA), I found one study that suggested that 80% of highly sensitized patients (like Patty) had either a reduction in their PRA or a change in the specificity of their antibodies after receiving treatment with rituximab. One pediatric patient saw a reduction of PRA from 55% to 18%. I wonder what it is about Patty that renders her incapable of realizing the antibody reductions that others have achieved. Perhaps the next round of PRA results will demonstrate that I'm speaking too soon.
The same research report said that there are 5,000 persons in the U.S. with a PRA above 80% awaiting kidney transplants at any given time; of these, only 300 receive a transplant each year, and these require strict adherence to anti-rejection protocols, because they have a much greater tendency to experience rejection episodes of some severity soon after transplant. This is a worry of ours -- will Patty receive a transplant, only to be subjected to a barrage of other medicines that render her even less capable of living a "normal" life?
The patient has awakened, so I'm going to sign off to spend some time with her. Please keep her in your best thoughts for a quick rebound from these troublesome meds.