SAN FRANCISCO -- The sun wasn't up at 5 o'clock Wednesday morning, but a new day had already dawned for Matthew Ouimet.
Matthew, a 2-year-old Antioch boy who had waited 15 months for a life-sustaining kidney and liver transplant, had his new organs. Dr. John Roberts took the lead on the liver transplant, and Dr. Peter Stock, who handled the kidney procedure in a 13-hour surgery that began around 6 p.m. Tuesday, delivered the good news to exhausted but smiling parents Kristi and Kelly Ouimet and a half-dozen family members who spent the night at UCSF Benioff Children's Hospital.
"They look pretty good," Stock said. "He's very stable."
Later Wednesday morning, complications, not unforeseen, provided a reminder of the sensitive nature of transplantation. Neither of Matthew's new organs had yet to operate at full capacity, and there was some bleeding around the liver. But Kelly Ouimet, after consulting with doctors, was assured that his son was on the road to recovery.
"There's some extra bleeding," Ouimet said shortly after noon. "It's not unusual. There's no (further) surgery (planned); there's no change in the treatment. We talked to a surgeon who said, 'This is acceptable. We're moving forward. This is not a sprint; it's a marathon.' "
Dr. John Roberts took the lead on the liver transplant. Dr. Peter Stock, who handled the kidney procedure, advised the Ouimets early Wednesday morning, even before Matthew was out of surgery, that there were reasons his new organs might be slow to "wake up."
"What he told us was that the kidney was an adult organ now on a pediatric blood flow," Ouimet said. "And the liver has to mend with the host. This is not completely unforeseen."
Doctors were keeping Matthew under sedation in ICU, his father said.
As of 1 p.m., the family planned to take a few hours to get some much needed sleep, Ouimet said. "We're going to leave Matthew alone for a while," he said. "We've seen him enough. We've kissed him enough."
"We're tired, but we're doing good," Kristi Ouimet said. "We've had lots of support from friends, family and complete total strangers. It's been remarkable."
Wednesday afternoon, Roberts confirmed in a statement that what Matthew has been experiencing is not out of the ordinary, especially for pediatric patients.
"Matthew's conditions have improved since this morning," Roberts said. "It's quite normal for new organs to take time to 'wake up' in a new patient, especially when the recipient is as young as Matthew. In the next 24 to 48 hours, we are looking to see how the new liver and kidney are functioning. We will continue monitoring Matthew's laboratory results for infection and any toxicity issues."
Matthew waited 15 months for his organs. For 23 months, he and his family had commuted to UCSF's pediatric dialysis unit -- a 94-mile round trip from their Antioch home -- six days a week for four-hour dialysis treatments.
The waiting continued even after donor organs were located Monday morning and proven to be a match. Surgery was delayed for 12 hours Tuesday.
The wait, Kristi Ouimet said Wednesday morning, was worth it.
"It makes me feel like everybody was telling the truth," she said, "and that he really is going to be OK."
Matthew was diagnosed with the genetic condition primary hyperoxaluria Type 1, which leaves the liver unable to cleanse harmful oxalates from the blood. The condition affects small organs in the body, usually starting with the kidneys, and led to him suffering end-stage renal failure when he was 5 months old.
Once the transplanted kidney -- only one was implanted -- and liver become fully functional, those concerns will be a thing of the past.
So will the commutes to dialysis, and the home treatments Kristi gave Matthew every night. One treatment was peritoneal dialysis, in which his abdomen was filled with fluid for two hours so that his skin would expand to accommodate his new organs.
"So that worked?" Kristi Ouimet asked Stock. "They fit OK?"
"They fit," Stock said, with a smile. "We shoehorned them in there."
As soon as a bile duct was inserted into the new liver, Stock told the family, Matthew would be taken to ICU. The toddler was wheeled out of surgery around 7:30 a.m. His parents finally got to see him in ICU around 9:35.
"We were able to kiss him and touch him, and tell him how much we love him, and how brave he is," Kristi Ouimet said. "So it was scary, but it was still very special. We really needed that. We needed to see that he was there and that he made it through the surgery."
Staff photojournalist Jane Tyska contributed to this story.
Follow Gary Peterson on Twitter @garyscribe.