Ukuze uqonde ukuthi kungani ukulahlwa kwesitho ngemuva kokufakelwa kwesitshalo kwenzeka nokuthi kubalulekile ukuqonda nje inqubo yokufakelwa komzimba , kodwa futhi nolunye ulwazi olubalulekile mayelana nesistimu yomzimba, izihlobo ezahlukene zabanikeli bomzimba, nokuthi lezi zinto ezimbili zingabangela kanjani ukuguqulwa kwesitho.
Kuyini Ukufakelwa?
Ukufakelwa kuyinkqubo yezokwelapha lapho izicubu noma isitho zisuswa emzimbeni munye futhi zifakwe emzimbeni owodwa ukuze zithathe isikhundla somzimba noma izicubu ezingasebenzi kahle, engekho noma ezigulayo.
Ukufakelwa kwezakhi zomzimba kwenziwa kuphela ngezifo ezinzima. Le nqubo ayenzelwe izifo ezincane noma ezilinganayo, kwenziwa uma isilwane sinesifo kangangokuthi ekugcineni kuyoholela e-dialysis noma ekufeni ngaphandle kokufakelwa kabusha.
Izingxenyana ezivame kakhulu zenziwa ngokuthatha isitho emzimbeni womuntu oyedwa, ophilayo noma oshonile, futhi wanyatheliswa emzimbeni womuntu. Amalungu, izicubu ezinjengesikhumba, i-ligaments, ne-tendon, futhi ngisho ne-cornea esweni lingatholakala bese kunikezwa umamukeli ukuthi aphathe izinkinga ezihlukahlukene.
Kungenzeka ukutshala izicubu zesilwane, njenge-a pig noma inkomo, bese uyisebenzisa kumamukeli womuntu. Enye yezindlela ezivame kakhulu ukuthi lolu hlobo lwezincuzi lungasetshenziswa yiziguli ezidinga i-valve yenhliziyo esikhundleni.
Ngokomlando, izitho zokufakelwa kabusha zithathwe emzimbeni womuntu oyedwa futhi zafakwa komunye umzimba womuntu. Kube nezimo ezingavamile zezingcingo ezisuswa kumuntu oyinhloko bese zifakwa kumamukeli womuntu.
Kulawa, odume kakhulu yi-Stephanie Fae Beauclair ka-1984, owaziwa kangcono ngokuthi "Baby Fae," owathola inhliziyo yezinyosi ezineminyaka eyi-11 ngaphambi kokufa ngenxa yokulahlwa yilezi zinsuku ezingu-31.
Izinhlobo zokudlulisa
Kunezinhlobo eziningi zokuguqula futhi uhlu olude lwezindlela zokuchaza izinqubo ezenza ukuguqulwa kwenzeke.
Ingozi yokulahlwa ihluka phakathi kwezinhlobo zabanikeli, njengoba umehluko phakathi komnikeli nomamukeli kungandisa amathuba okulahlwa. Ngenxa yalesi sizathu, ukuqonda uhlobo lokufakelwa kungasiza ekunqumeni ingozi yokwenqatshwa futhi kungasiza ngisho nethimba lezokunakekela ukunquma ukuthi imithi edingekayo ukusiza ukuvimbela ukwenqatshwa.
Nasi uhlu olufushane lwamagama asetshenziselwa izinhlobo ezahlukene zokufakelwa.
I-Autograft: izicubu zithathwe kwenye ingxenye yomzimba futhi zifakelwe enye ingxenye yomzimba ofanayo. Isibonelo, ngemva kokushisa okukhulu, isiguli singase sibe nesigcawu sekhanda esithathwe emlenzeni wabo. Lokhu kuthuthukisa amathuba okuphulukiswa kwe-graft kahle, futhi izinkinga zokulahlwa cishe azikho njengoba umnikeli nomamukeli bengafani.
Allograft: lolu hlobo lokufakelwa umuntu ngumuntu wokufakelwa kwezicubu, izitho, noma i-corneas. Umnikeli ungumuntu ohlukile kunomamukeli futhi angeke abe nesiginali esifanayo (njengamawele afanayo). Kukhona ingozi ephawulekayo yokwenqatshwa nalolu hlobo lokufakelwa komzimba.
Isograft: lolu hlobo lokufakelwa kabusha lwenziwe phakathi komnikeli ozofuzo olufana nezofuzo kanye nomamukeli, njengelinye iwele elifanayo.
Kukhona neze engozini yokulahlwa kuleli cala, njengoba umzimba ungaqapheli i-twin organ efanayo ehlukile.
Xenograft: lolu hlobo lokufakelwa luphakathi kwezinhlobo ezahlukene . Lezi zinhlobo zezinto eziphilayo zokufakelwa kwezinhlobo zezilwane, njengezinambuzane kubantu noma ingulube kubantu. Ngokuvamile, lezi ziyizicubu zomzimba kodwa ezimweni ezingavamile ziye zaba izingxenye zomzimba. Kukhona ukulindela ubungozi obukhulu ngalolu hlobo lokufakelwa komzimba, kodwa ngokuvamile ukuguqulwa kwezicubu kunikeza ingozi encane yokwenqatshwa.
Izinhlobo ze-Organ Donors
Kunezinhlobo ezintathu zezinsizakalo zomzimba okufanele ziqaphele.
I-Cadaveric Donor: izicubu zomuntu oshonile, izitho, kanye / noma i-corneas zishintshwa zibe ngumamukeli ophilayo ophilayo.
Lolu hlobo lweminikelo lunalo izinga elifanayo lengozi njenganoma imuphi omunye umnikezeli ongathinteki ngaphandle kokuthi ukuhlolwa kofuzo kuthatha umdlalo phakathi komnikezeli nomamukeli kungcono kunokujwayelekile.
I-Donor ehlobeneyo yokuphila: umnikeli wesintu ophilayo uhlinzeka isitho esihlotsheni esidinga ukufakelwa komzimba. Ukufakelwa kungase kube kancane kancane ukwenqatshwa ngenxa yokufana kofuzo phakathi komnikeli nomamukeli.
I-Altruistic Donor: umnikeli ophilayo ukhetha ukunikeza isilwane kumamukeli ongathintana naye. Lolu hlobo lweminikelo lunalo izinga elifanayo lokubeka ingozi yokulahlwa njenganoma yimuphi omunye umnikezeli ongathinteki ngaphandle kokuthi umnikeli nomamukeli abe nomdlalo omuhle kakhulu wezakhi zofuzo.
Ukulahlwa kwegciwane
Iningi lezingxenyana ezenziwe e-United States empeleni zithutha izicubu . Lezi zintambo zingase zibe amathambo, imigamu, izintambo, ama-valves enhliziyo, noma ngisho nama-graft esikhumba. Kulaba abamukeli kukhona ezinye izindaba ezinhle kakhulu: abancinci kakhulu ukuzwa lezi zicubu .
Ukuze abamukeli bezitho, ukulahlwa kwesigungu esisha kuyinkinga yokubaluleka okunjalo okudinga ukuqapha njalo ngokusebenzisa umsebenzi wegazi, imithi yansuku zonke, kanye nezindleko ezinkulu. Ukwenqaba kusho ukuthi umzimba ulahla isitho esisha ngoba ubona njengowommpi wangaphandle ofana nokutheleleka okungafuneki. Kungenzeka ukuthi ukulahlwa kungukukhathazeka njalo kwabamukeli bokufakelwa ngoba ukulahlwa kungase kusho ukubuyela kokwelashwa kwe-dialysis noma ngisho nokufa ngenxa yokuhluleka komzimba.
Indlela uhlelo lokuzivikela komzimba olusebenza ngayo
Amasosha omzimba ayinkimbinkimbi futhi anzima kakhulu, futhi ezimweni eziningi enza umsebenzi omangalisayo wokugcina umzimba womuntu kahle. Amasosha omzimba enza izinto eziningi, evikela umzimba kusuka kumagciwane, amagciwane, nezifo kanye nokusiza inqubo yokuphulukisa. Ukusho ukuthi isimiso somzimba samasosha omzimba siyinkimbinkimbi ngempela, njengoba izincwadi zonke zilotshwe kwisistimu yomzimba nokuzivikela komzimba.
Ngaphandle kwesimiso sokuzivikela emzimbeni, sasingeke sisinde ebusheni njengoba singeke sikwazi ukulwa ne-bacterial-exposure encane kunazo zonke ngisho nokubandayo kungaholela ekufeni. Amasosha omzimba akwazi ukubona ukuthi yikuphi "uqobo" futhi asemzimbeni futhi angakwazi ukubona ukuthi yikuphi "okunye" futhi alwe.
Loluhlelo luvame kakhulu ukugcina kahle umuntu ngamunye nokugcina izinto ezimbi emzimbeni, noma ukulwa nalo uma ungena emzimbeni. Isivikelo somzimba sokuzivikela asihlali ngaso sonke isikhathi izinto ezingangeni emaphashini noma egazini noma ekudaleni ukutheleleka, kodwa kuphumelela kakhulu ekulwa nabo.
Amasosha omzimba nawo angabangela izinkinga lapho kungaboni kahle "ukuzibona" njenge "enye." Lolu hlobo lwenkinga lubhekwa ngokuthi "isifo sokuzimela" futhi lubhekene nezifo ezinzima ezifana ne-lupus, multiple sclerosis, i-ulcerative colitis, uhlobo lwesifo sikashukela , ne-arthritis ye-rheumatoid. Lezi zifo zonke zibangelwa isimiso somzimba sokuzivikela senziwa ngaphandle kwesizathu esihle, futhi imiphumela ingaba yinkimbinkimbi.
I-Immune System nokulwakala kwe-Organ
Endabeni yokuguqulwa komzimba, inselele enkulu-emva kokuthola isitho esifanele ukufakelwa kabusha-ukugcina isilwane esisha siphilile ngokuvimbela ukwenqatshwa. Lokhu kuvame ukwenza ngemithi, noma imishanguzo eminingi, eyasiza ukukhohlisa umzimba ukuba uqaphele "okunye" njengokuthi "uqobo." Ngokusobala, isimiso somzimba sokuzivikela sidinga ukucabanga ukuthi isilwane esisha siyingxenye yomzimba, kunesidumbu akuyona eyakhe.
Ukukhohlisa isimiso somzimba samasosha omzimba kuyinselele kunokuba kubonakale sengathi umzimba uhle kakhulu ekuboneni abahlaseli ngoba kubalulekile ekuphileni. Kubantu abaningi, isimiso somzimba samasosha omzimba siba namandla kakhulu futhi sinamandla phakathi neminyaka yokuqala yokuphila futhi sikwazi kangcono ukulwa nokutheleleka ngonyaka odlule kahle kuze kube umuntu omdala.
Ucwaningo lusiza ukufakelwa kweziguli ukulwa nokulwa nokukhishwa kwesifo, ngokusiza ekunqumeni ukuthi amasosha omzimba ahlonza kanjani umzimba kanye nesigungu ngokuthi "enye" emva kokufakelwa. Ukuthola ukuthi iyiphi ingxenye yamasosha omzimba aqala izinyathelo eziningi ekunqatsheni kusho ukuthi ekugcineni indlela yokuvimbela ingadalwa.
Yini Eyenza Ukunqunywa Kwegciwane?
Kukholelwa ukuthi ukuba khona kwegciwane kuqala kukhonjiswe ngokuthi "okunye" lapho i-protein ye-SIRP-alpha ibophezela kumamukeli omncane ongenqamuzana legazi elimhlophe. Ukusuka lapho, kwenzeka ukukhipha uketshezi okungaholela ekuqatsheni komzimba ngokuphelele uma kungabanjwa ngesikhathi noma uma imithi ingaphumeleli ekulawuleni ukusabela.
Abacwaningi bacabanga ukuthi njengezinhlobo zegazi, kuzoba nezinhlobo ze-SIRP-alpha, futhi ngokuhlola umnikeli nomamukeli banganciphisa ingozi yokukhishwa kokufakelwa ngaphambi kokuba ukuhlinzwa kwenziwe ngokufanisa izinhlobo zomnikazi we-SIRP-alpha. Lokhu kunganciphisa ingozi enkulu yokwenqatshwa, ukunciphisa inani lemithi edingekayo ekuvimbeleni ukwenqatshwa, futhi ngaphezu kwakho konke, kusiza ilungu lihlale isikhathi eside kumamukeli.
Ukunciphisa Ingozi Yokulahlwa Ngaphambi Kokufakelwa Ukutshala
Kunezivele izindlela eziningi ukuthi ithuba lokukhishwa linciphile ngaphambi kokuhlinzwa, okokuqala ngokubalulekile ngokuqinisekisa ukuthi umamukeli kanye nomnikezeli banezinhlobo ezihambisanayo zegazi, bese beqhubekela phambili ekuhloleni okunye okuyisimanje namasu.
Uma umnikeli engumhlinzeki ophilayo, isihlobo sivame ukukhethwa ngoba amathuba okulahla ayancipha. Singase sithole esikhathini esizayo ukuthi lokhu kungenxa yokuthi imindeni ibe ne-SIRP-alpha engcono, kodwa ngalesi sikhathi yinto eyodwa kuphela.
Ukuhlolwa kofuzo kuyenziwa futhi ukwenza umlingisi ongcono kakhulu womnikeli. Lokhu kubaluleke kakhulu ngokuguqulwa kwezinso, njengoba ukufanelana okuhle kuholela ekusebenzeni iminyaka engaphezulu kwemisebenzi yomzimba.
Lindela ukubona ucwaningo olusiza ukwenza ukuhlelwa kokubili okungcono phakathi koxhasi nomtholampilo womtholampilo, kanye nokucwaninga okwengeziwe ukuze "ukhiphe" izingxenye zamasosha omzimba ukuvikela ukulahlwa.
Ukunciphisa Ingozi Yokulahlwa Ngemva Kokutshala
Njengamanje, emva kokufakelwa kwesilwane sekuphelile, imiphumela yebhu labuguli kanye nohlobo lokufakelwa kuyosiza ukubeka uhlobo lwemithi kanye nemithi yemithi enikezwa ukuvimbela ukwenqatshwa ukufakelwa.
Ama-Labs azohlale eqashwe emavikini nasezinyangeni emva kokufakelwa, bese imvamisa iyanciphisa iziguli eziningi ngemuva konyaka wokuqala. Noma kunjalo, isiguli sizofundiswa ukubheka izimpawu zokwenqatshwa nokuqapha ngokulondoloza impilo yabo.
Ukubuka ukulahlwa, ukulungisa imithi ngokusekelwe kokusongela noma ukutholakala kwangempela kokulahlwa, nokuphindaphinda kuvamile. Lokhu kwenziwa ukunquma ukuthi isiqephu sokulahla sixazululwe yini umamukeli wokufakelwa okujwayelekile okufanele abhekane nayo ukuze alondoloze impilo yakhe.
Esikhathini esizayo, njengoba kuqhutshelwa phambili ekunciphiseni amasosha omzimba, iziguli zingadinga imithi encane, ukuqapha kancane, nokuzwa impilo engcono yokuguqula isikhathi eside. Lokho kusho ukuthi ucwaningo kufanele luholele emithini ephumelelayo kakhulu ekwazi ukuyeka ukwenqatshelwa ukuthi ingenzeki noma ingayeka ukuqhubeka kwenqatshelwe uma itholakele.
> Imithombo:
> Abacwaningi bacabange ukuthi bathole imbangela yokulahlwa kwegciwane ezigulini zokutshala. I-NPR. http://wesa.fm/post/researchers-think-theyve-found-cause-organ-rejection-transplant-patients#stream/0
> I-donor i-SIRPα i-polymorphism ihlunga impendulo ye-immune yangasese kuma-grafts allogeneic. Isayensi ye-Immunology. http://immunology.sciencemag.org/content/2/12/eaam6202