Patty and Sarah returned home this evening. We are encouraged to learn that all her important readings from her liver panel - bilirubin, AST, ALT, GGT - are continuing to drop into the normal range. Patty learned some interesting things from Dr. Christie during her stay and she may share some of her reflections later in the week.
First and foremost in need of prayer is the blood flow through Sarah's kidney to her heart. As it was explained to Patty, blood flows from the spleen and intestines up through the liver into the heart. At this point in time while the pathway to the liver is fine, due to the scar tissue from the Kasai procedure, it is slow going for the blood into the liver. Things are complicated by what Dr. Christie referred to as "bile lakes" inside the liver which make it tougher for the blood to quickly flow through the liver. We need prayer that the scar tissue around the area connected directly to the intestines will heal, allowing a better flow of blood.
Dr. Christie has recommended ultrasounds every three months to monitor the blood flow as that is the only way to accurately track it. What they don't want to see happen is the liver continue to have issues pumping blood through. This can lead to the blood backing up the spleen and enlarging it. The spleen then makes its own "alternate route" for the blood, sending it back up the esophagus to the heart. This can cause some damage to the esophagus and enlarge the spleen.
Looks like we have to ramp up the prayers for Sarah. While a transplant is likely in well over 50% of biliary atresia cases, we are still believing God can completely heal her.