Ukufakelwa kwenhliziyo yindlela yokwelashwa ejwayelekile yegolide yeziguli ezinezinhliziyo eziphuthumayo-okusho ukuthi akukho ukwelashwa okungcono. Kodwa akuphelelanga. Odokotela abazinakekela lezi ziguli bahlale befuna izindlela zokuthuthukisa ukwelashwa.
Izindaba ezinhle ukuthi abantu abaningi abadinga ukufakelwa kwenhliziyo bayithola iminyaka eminingi, iziguli ezimbili kuphela kuya ku-2 500 ngonyaka zathola inhliziyo entsha.
Ngonyaka ka-2015, lelo nani lenyuke laba ngu-2,804. Ngo-2016, kwavuka futhi kwaba ngu-3 191.
Ngeshwa, izinhliziyo ezinempilo ezanele azihlinzekiwe ukuqinisekisa ukuthi wonke umuntu odinga inhliziyo entsha uthola eyodwa. Odokotela babheka izindlela zokucabanga ngesistimu yokwabiwa kwamalungu ukuze labo abasengozini enkulu baqale ukufakwa.
Okwenza Umuntu Adinge Ukufakelwa Kwezinhliziyo
Abantu abangaba yizigidi ezingu-5.7 e-US banesifo senhliziyo. Lokhu kusho ukuthi izinhliziyo zabo azikwazi ukupompa ngendlela efanele, ngokuvamile ngenxa yokulimala okuvela enhliziyweni, ukucindezeleka kwegazi, isifo sikashukela, i-valve ekhubazekile, noma isifo senhliziyo esibizwa ngokuthi i-cardiomyopathy. Laba bantu bahlangabezana nezimpawu ezingase zihlanganise ukuphefumula okudlulele ngokweqile, ukukhathala, ukuqongelela ngokweqile kwamanzi emilenzeni nasezinkathini, nokukhathazeka ukuphefumula uma ulele phansi.
Iziguli zokuhluleka kwenhliziyo zidinga imithi ukusiza izinhliziyo zabo ukuba zenze isivumelwano kakhulu, ziqede uketshezi ngokweqile, futhi zandise ukugeleza kwegazi.
Le mithi inganciphisa ukuqhuma kwenhliziyo, ukuyikhupha ngaphandle esibhedlela, nokuyivimbela ekufeni. Kodwa ngokuhamba kwesikhathi, imithi ingayeka ukusebenza. Kuleli phuzu, ukufakelwa kwenhliziyo kungase kube yedwa okukhethwa kukho.
Ngubani okufanele athole ukufakelwa kwenhliziyo
Imikhombandlela yokuthi ngubani ofanelekayo ukufakelwa kwenhliziyo nokuthi ngubani ongaqondakali.
Isikhungo ngasinye sokufakelwa ukuzikhethela ukuthi iziphi iziguli abazozithatha.
Umfutho wegazi ophezulu wegazi uyisinye sezimo zezokwelapha kuphela ezingavumelani nesiguli esiphambanweni senhliziyo. Ngaphezu kwalokho, izikhungo eziningi ngeke zifakelwe inhliziyo enogulini okungenakwenzeka ukuthatha imithi abayidingayo ngemva kokuhlinzwa ukuze kuvinjelwe inhliziyo yabo entsha. Izikhungo eziningi zidinga ukuthi abakhethiwe babe mahhala kwezidakamizwa nokuphuza utshwala iminyaka emibili ngaphambi kokufakelwa kwenhliziyo, kanye nokubhema kwentuthuko isikhathi.
Ayikho i-cutoff yobudala ye-transplantation yenhliziyo, kodwa:
- Ingxenye yeziguli ezithola inhliziyo entsha ineminyaka engama-50 kuya ku-64. Abantu kule nkathi yobudala bavame ukwenza kahle futhi bangalindela ukuba baphile iminyaka eyishumi kuya kwengu-11 ngemuva kokuthi bathathe imithi yabo yokulwa nokulahla.
- Abantu abadala abaneminyaka engama-70 basengozini enkulu, ngoba kungenzeka ukuthi banezinye izimo zezokwelapha.
- Iziguli ezineminyaka engamashumi amabili nantathu ubudala kanye nama-20s asekuqaleni zivame ukuba izingozi futhi zivame ukumisa imishanguzo yabo yokulwa nokulahla. Uma benza, imiphumela ingaba yingozi.
- Izingane ezidinga ukufakelwa kwenhliziyo zivame ukwenza kahle kusukela isimiso somzimba sokuvikela omzimba singaphansi kokuthuthukiswa futhi abazali baqinisekisa ukuthi bathatha imithi yabo.
Ukuvimbela Ukulahlwa
Imithi yokulwa nokulahlwa igxilisa amandla omzimba, ngakho umzimba awubukeli inhliziyo entsha njengomzimba wangaphandle futhi uwuhlasela.
Kwaphela iminyaka, i-cyclosporine yayisetshenziselwa ukuvimbela ukwenqatshwa. Namuhla, amaphesenti angu-90 weziguli asebenzisa i-tacrolimus.
Ngenxa yokuthi i-tacrolimus inamandla futhi inamandla kakhulu, kuncane okudingekayo ukuvimbela ukwenqatshwa okubuye kunciphise imiphumela emibi. Kodwa-ke, iziguli ezingenakuphika inhliziyo yenhliziyo-labo asebekhulile, besilisa, kanye / noma i-caucasian-kaningi benza ngcono ngesidakamizwa esibuthakathaka.
Ukuhambisa iPump Mechanical
Njengoba izinhliziyo ezingenayo okwanele zihamba ngokuzungezile, ukusebenzisa ipompo ye mechanical njengenhliziyo engaguquki yendawo ingxoxwa. Amadivaysi okusiza nge-ventricular (ama-VADs) nezinhliziyo eziphelele zokufakelwa zivame ukusetshenziselwa okwesikhashana ukusiza inhliziyo ehlulekayo ngenkathi isiguli silinde ukufakelwa ("ibhuloho kuya kokufakelwa").
Zonke iziguli ezinezinye zala madivaysi zifakwe kwi-Registry ye-Interagency ye-Support Mechanically Assistance Support (INTERMACS). Ngokuhamba kwesikhathi, ulwazi oluqoqwe kule database luzosiza odokotela banqume ukuthi amadivaysi okufakelwa angaba yini indlela ephephile futhi ephumelelayo enhliziyweni yomuntu.
Ukunikezwa komzimba
Lapho uhlala khona kuthinta amathuba akho okuthola inhliziyo entsha noma ufe ngaphambi kokuba inhliziyo itholakale. Inani lokufa ngenkathi ulinde ukufakelwa kwezitshalo lihluka ngobuso kusuka kwamaphesenti amathathu kuya kwangu-22. Iziguli ezihlala kude nesikhungo esiseduze sokufakelwa kwenhliziyo zingenakuthola ukuthola inhliziyo kunalabo abahlala eduze. Kodwa lena akuyona indaba yonke.
Njengamanje, iziguli ezilindile zifakwa ezigabeni ezibanzi futhi zihlukaniswa nohlobo lwegazi, ubukhulu, nobudala. Kunentshisekelo ekhulayo ekuboneni izici ezibeka isiguli engozini enkulu yokufa ngaphambi kokuba bathole inhliziyo. Lokhu kuzovumela izinhliziyo ezitholakalayo ukuba zifike ezigulini ezigulayo kuqala, kungakhathaliseki ukuthi zihlalaphi.
Noma kunjalo, isidingo sezinhliziyo ezivela kubanikeli abanempilo, abasencane bayaqhubeka nokuphumula ukunikezwa. Ungasiza ngokubhalisa ukuze ube umhlinzeki womzimba lapha futhi uhlole ibhokisi kulayisensi yakho yokushayela. Ngisho noma usemdala kakhulu ukuba unganikeli inhliziyo ngesikhathi sokufa kwakho, amehlo akho, isikhumba, noma ezinye izitho zingase zizuze umuntu oyedwa noma ngaphezulu.
UDkt. Hsich uyisifo sezinzwa zezinhliziyo esihlose ukufakelwa kwenhliziyo. Ungumqondisi wezokwelapha ohlanganyelwe ohlelweni lwe-Cleveland Clinic's Transplant Program, noMqondisi weKliniki Yokuhluleka Kwezinhliziyo Zomama.