Chart Note 1/24/24 9:30 am

Going back to the OR

Yesterday Hayley was move out of the ICU room to a very nice, large room on the transplant ward. She has her own bathroom now, and Matt gets to sleep on a pullout couch instead of a recliner chair! Norene was here to help with the move, and she brought decorations! Hayley spent some time yesterday with Julie during the day and with Megan in the evening, relaxing and getting prepared mentally for the second operation. Emma called this morning, to give love and well wishes before surgery.

Hayley is going to the OR this morning at about 11:00 (actually, as I am writing this update, transport came to her room to take her to the pre-op area). The transplant surgeon who did her first operation on 1/19 is not on service this week, but he wanted to complete Hayley’s transplant, so he will be doing the surgery today. This operation will be much easier than the first. Hayley’s new liver seems to be functioning well, but currently the bile being produced by the liver is draining into a catheter coming out through her abdomen into a bag. That bile needs to be connected to the intestine to flow like it should inside of her body.

Normally, bile is produced by liver cells and drains through a series of bile ducts into the duodenum (the first portion of the small intestine). Bile is important for carrying away waste and for breaking down fats during digestion. When bile flow is obstructed, it backs up and destroys liver cells. Hayley needed her first transplant because PSC (primary sclerosing cholangitis) caused narrowing and blockage of bile ducts, and she needed her second transplant because the connection of bile duct to intestine scarred over time and caused blockage of bile flow. So this surgery today (making a good connection of bile duct to intestine) is very important!

Hayley is feeling positive and confident this morning, and she knows she is in good hands. We will give the next update later today after the operation.