TRANSPLANT DAY!

EEK! The day is finally here. July 16, 2025 Ariana's re-birthday! I wrote a lot of this blog post prior to today, but I wanted to start with asking for prayer.

Now on to the update! We were admitted back to the hospital on July 8, 2025. It was a very big day. We admitted through the surgery center because Ariana was having one of her ovaries removed for preservation and she needed a new port placed.

Ovary Removal for Preservation

About a month ago, one of the oncology doctors approached Patrick and me to discuss Ariana's fertility. Honestly, it was a crazy conversation because we were talking about this subject for our 19 month old baby! Today, just thinking back on that conversation it throws me off. Regardless about my feelings though, the conversation was necessary.

The doctor explained that since Ariana was going to transplant, that her conditioning chemotherapy regimen would be at a pretty high dose. With this high dose, the goal is to completely wipe out all out her diseased and existing bone marrow. This is called myeloablation. The drugs (Busulfan and Cytoxan) also are used to suppress her immune system in preparation for the bone marrow transplant. These drugs target rapidly dividing cells like her red blood cells, white blood cells and platelets. Unfortunately, rapidly diving cells also includes germ cells in the ovaries, which means there’s a high likelihood of permanent infertility.

We were told that in recent years, there has been a greater push to preserve fertility before transplant begins, especially in pediatric patients. The plan was to remove one of her ovaries and send it to a preservation facility where her tissue can be stored for potential future use.

It still feels unreal. She's just a baby. She’s just learning how to say things like "Thank you, Mum" and "All done." It’s mind-boggling. But these are the hard things you have to think about with pediatric cancer. It feels unfair. Yet we’re incredibly grateful to live in a time when this is even possible—that we can provide her with some future choices, when so much has been out of her control.

Once we understood the benefits of this option and got all our questions answered, we agreed and decided to move forward with the preservation.

Mediport Placement

As you may recall, Ariana has had her central line port since the beginning of her induction 1 cycle of chemotherapy. As I have stated, transplant chemotherapy is much more intensive and requires additional monitoring on her organ function. With this being said, we were told that Ariana would need a mediport implant going into her transplant admission.

For a lot of cancer treatments, a mediport is a pretty standard thing. Since Ariana was diagnosed with AML, and we knew that she would be on a more aggressive chemotherapy plan, a Central Line was recommended because it had two lumens (two access points). The mediport only has one access point, which is sufficient for most cancer treatment plans and carries a lower infection risk since it is implanted under the skin. All this to say, Ariana, in total, would have 3 lumens or access points that the medical staff could use, if needed, during her transplant admission.

What's really exciting about this port placement is that after transplant is done, she will be able to get her central line port completely removed and will just have this implanted one. It's exciting because when this port is not being used (not accessed) it has little to no infection risk, she can get it wet (enjoy a tub bath again, go in the pool), has much less maintenance and is good for a long time. We were told that she will more than likely have it close to about 15 months. It's a great alternative to her having to get poked for blood draws.

Here is a video of how the port is placed. I do not recommend watching if you are queasy about medical interventions. It's a cool device though and it's amazing how these things happen.

Luckily, she had both of these procedures done under one anesthesia event and was out of the operating room after about 1.5 hours.

Now on to the transplant details...

Ariana had a successful ovary removal and port placement procedure when we were admitted on the 8th. She was pretty sore the day of the procedure and rested in bed the majority of the day. During the procedure they actually found two hernias she had and fixed them while they were in there already - which contributed to her being even more sore. Once that sun rose again, she was ready to get moving around again!

She conquered her conditioning regimen that started on July 9th and ended on July 14th, and had a rest day (no drugs) yesterday. We are so grateful that she has had a strong start and it just solidifies that this was her time for transplant.

As we have stated, Ariana will receive her transplant from Patrick, her father. He is in great spirits and is feeling really good about the procedure. It is so special to him that he can be her donor. This type of transplant is called an allogeneic stem cell transplant because Ariana is receiving cells that aren't her own. I found this AMAZING video that concisely describes the process. Please give it a watch.

I don't think I could have said it any better! Since Ariana is so tiny, her transfusion is expected to take less than an hour. Patrick's procedure will also be about an hour and then hopefully he can come up to the room quickly so that he can witness the transfusion.

During and after the transfusion is complete, the doctors and nurses will be monitoring her super closely. As the video described, this transplant carries a lot risk. The big one being Graft Vs Host Disease. I won't talk much about this because we are manifesting and praying for no complications! All I will say that there is risk for this to occur, but she is in a great place health wise and age wise that lowers this risk. Additionally, her care team are experts and will be on top of any complication if they occur.

We have already been warned that these next two weeks Ariana will be at her weakest and most vulnerable. So we also ask that you keep her in your prayers and uplift her each day.

Ariana continues to thrive. She is walking a ton! She has four more laps around the unit to hit a mile! We are still watching Wicked almost daily. Overall, we are having really good days and we are soaking up each minute. We are staying hopeful that this stay remains uneventful and that she feels well.

Thank you all for your incredible support on this journey. We can’t believe we’ve made it to transplant day—her forever cure. Your prayers, love, texts, donations, and encouragement have carried us through.

We’re so blessed to have each of you as part of Ariana’s journey. From the bottom of our hearts—thank you.