Ukuqonda Izimo Nezimfanelo Ze-Transplantation Yezingulube
Ukufakelwa kwesibindi ngezinye izikhathi kuyindlela yokwelashwa kuphela kubantu abanezifo ezinzima noma ezingapheli zesibindi. Ukuthuthukiswa kokufakelwa kwesibindi kuye kwaba nemiphumela ephakeme kakhulu yokulinda impilo, kanti abangu-58% wabamukeli basinda iminyaka engu-15.
Ukufakelwa kwesibindi kwenziwa kuqala ngasekupheleni kweminyaka yama-1960, nakuba babelokhu bezama kakhulu phakathi nawo-1980 lapho bekhona amasu okuhlinzeka kangcono nezindlela ezingcono zokuvimbela ukuchithwa kwamagatsha okuxhunyelelwa.
Namuhla, ukufakelwa kuka-6,000 kwesibindi kwenziwa njalo ngonyaka.
Ukugqugquzela Izizathu Zokufakelwa Kwebindi
Ngenxa yokuthi ukufakelwa kwesibindi kuyabiza futhi kubhekene nobungozi obukhulu, odokotela batusa njengento yokugcina. Lokhu kwenzeka uma isibindi singasasebenzi, futhi izinkinga ezivela ekulimazeni kwesibindi azikwazi ukulawulwa.
Phakathi kwezizathu ezivame kakhulu zokufakelwa kwesibindi:
- I-cirrhosis yokuphela kokuphela kwesisusa kunoma yikuphi imbangela, kuhlanganise nesifo sofuba esingenasifo esibelethweni B noma C, isifo se-cirrhosis esiphuzayo, nesifo esingenalo utshwala esinamafutha. Ngenkathi i-cirrhosis ngokwayo ingeyona inkomba yokufakelwa, izibonakaliso zokukhokha (njengezinkinga zokukhulelwa ngokwegazi, ukuphaphaza kwamanzi, noma ukwenyuka kwama- ascites ) kungase kusebenze njengesisusa.
- Amanyevuza e-fover, i-cholangiocarcinoma, i-hepatocellular carcinoma (i-HCC), i-primary hepatocellular malignancies kanye ne-adenomas ye-hepatic.
- Ukuhluleka kwe-Fulminant hepatic ngenxa ye-hepatitis ye-viral (A, B, D futhi engajwayelekile C), ukuhluleka kwesibindi okuhlobene nemithi, ukuhlushwa kwe-hepatic, isifo sikaWilson noma ezinye izimbangela.
- Ukungasebenzi kahle kwezidakamizwa ze-bile, okubangelwa yi-cirrhosis ye-biliary ne-sclerosing cholangitis.
Ukufanelekela ukufakelwa kwesibindi
Akumangalisi ukuthi abantu abaningi badinga ukufakelwa kwesibindi kunokuba kutholakala ukufakelwa. Ngenxa yalokhu, ochwepheshe bezinqubomgomo zempilo baye bahlakulela isiqephu seModeli yokuQeda isibindi sesifo sesibindi (MELD) , i-algorithm esebenzisa ukuhlola ubunzima besifo esingenasifo sesibindi nokusiza iziguli ukuba zibeke phambili.
Ezinye izindlela zokuzimisela zingasetshenziswa, kuhlanganise neMigomo yaseMilan , efaneleka umuntu ngokusekelwe ngobukhulu kanye / noma isibalo sezilonda zesibindi (okungukuthi, akukho mkhulu kunezingamamitha angu-5, noma okungaphezu kwezinguquko ezintathu ezilingana noma ngaphansi 3 amasentimitha ngobukhulu).
Nakuba ukuguqulwa kungathathwa njengokusebenza kunoma yisiphi isimo esibucayi noma esingapheli esibangela ukukhubazeka okungenakuphikisana nokuhlala unomphela, kungase kube khona izinyathelo eziningana ekwenzeni izinqumo.
Inhlangano e-US enesibopho sokufanisa nabantu abanezimboni ezitholakalayo yi-United Network for Organ Sharing (UNOS). Inhlangano engeyona inzuzo isebenza ngaphansi kwenkontileka yohulumeni waseHerald ukufanisa nokwabelana izitho.
Ukuqhathaniswa kwe-Transplantation yesibindi
Ukungafani kokufakelwa kwesibindi yilabo abangakwazi ukwandisa amathuba okufa komamukeli noma kungabangela ukuhluleka noma ukwenqatshwa ukufakelwa. Phakathi kwamanye okungafani okuphelele okufakelwa kabusha:
- Utshwala wamanje noma ukuphuza ngokwemithi
- Isifo senhliziyo noma isifo samaphaphu
- Amanqamu (hhayi afaka ezinye izifo zomdlavuza wesibindi noma umdlavuza wesikhumba ongenayo i-melanoma)
- Ukukhubazeka okukhulayo nokuningi okuzoholela ekufeni kwangaphambi kwesikhathi
- Izifo ezithile ezingalawuliwe noma izifo ezisongela ukuphila
Kunezinamba eziningi zokuphikisana okuhlobene , okubizwa ngakho ngoba kungenzeka noma kungaphikisani ukwelashwa okusekelwe ekuhloleni kwesinye sezici eziningana, kubandakanya:
- Ubudala obudala (iminyaka engaphezu kwengu-65)
- Ukuhluleka kwezinso
- Ukukhuluphala komzimba
- Ukungondleki okukhulu
- I-HIV (nakuba ingaphansi kokukhathazeka kweziguli ezine-viral control)
- Umfutho wegazi ophezulu we-pulmonary
- Izifo ezinzima ezingalawulwa (noma ezingaphenduliwe) zengqondo
Imithombo:
I-American Liver Foundation. "Okungaphezulu Kokunikezwa Kwemvelo." ENew York, eNew York; ibuyekezwe ngoJanuwari 15, 2015.
Duffy, J .; I-Vardanian, A .; UBenjamin, E .; et al. "Izimpawu zokufakelwa kwesibindi ku-Hepatocellular Carcinoma kufanele zandiswe." Ama-Annal of Surgery. Septemba 2007; 246 (3): 502-511.
Iruzubieta, P .; Crespo, J .; kanye noF Fabrega, E. "Ukusinda Kwesikhathi Eside Nesikhathi Emva kokufakelwa Kwebindi Ngezifo Ezibangelwa Izidakamizwa." I- World Journal of Gastroenterology. Disemba 28, 2013; 19 (48): 9198-9208