He aha ka Living Donor Kidney Transplant? Ke Kumu, ke Kaʻina Hana & Nā Hopena

ʻO ka living donor kidney transplant he hana ʻoki e hāʻawi ai ke kanaka olakino i kekahi o kā lākou mau puʻupaʻa i kekahi kanaka i hāʻule a i ʻole e hāʻule ana nā puʻupaʻa. Hāʻawi kēia lapaʻau e ola ana i ka manawa maikaʻi loa no ka holomua lōʻihi e hoʻohālikelike ʻia me nā koho pani puʻupaʻa ʻē aʻe.

ʻAʻole like me ke kali ʻana i kahi puʻupaʻa mai kekahi mea i make, hiki i ka hāʻawi ola ke hana i ka transplant ke olakino maikaʻi ʻoe a me kāu mea hāʻawi. Hiki i kou kino ke hana maikaʻi me hoʻokahi puʻupaʻa olakino, kahi e hiki ai kēia makana kupaianaha o ke ola.

He aha ka living donor kidney transplant?

ʻO ka living donor kidney transplant e pili ana i ka wehe ʻana i kahi puʻupaʻa olakino mai ke kanaka ola a me ka waiho ʻana i loko o kekahi me ka hāʻule ʻana o ka puʻupaʻa. Lawe ka puʻupaʻa i hāʻawi ʻia i ka hana o ka kānana ʻana i ka ʻōpala a me ka wai nui mai kou koko.

Hiki i kēia ʻano transplant ke hele mai mai nā lālā o ka ʻohana, nā hoaaloha, a i ʻole nā ​​malihini lokomaikaʻi e makemake e kōkua. Hele ka mea hāʻawi i ka loiloi olakino a me ka noʻonoʻo nui e hōʻoia i ka olakino e hāʻawi palekana. I kēia manawa, e hele pū ʻoe i ka hoʻāʻo ʻana e hōʻoia e mākaukau ʻoe e loaʻa ka puʻupaʻa hou.

ʻO ka mea nani e pili ana i ka hāʻawi puʻupaʻa, ua hānau ʻia nā kānaka me ʻelua puʻupaʻa akā pono hoʻokahi wale nō e ola i ke ola maʻamau a olakino. E ulu iki ka puʻupaʻa i koe e mālama i ka hana keu, a ʻaʻole ʻike ka poʻe hāʻawi i nā pilikia olakino lōʻihi.

No ke aha e hana ʻia ai ka living donor kidney transplant?

Paipai ʻia ka living donor kidney transplant ke hiki ʻole i kāu mau puʻupaʻa ke kānana i ka ʻōpala a me nā mea ʻawaʻawa mai kou koko. Hāʻawi kēia hana iā ʻoe i ka manawa maikaʻi loa e hoʻi i ke ola maʻamau a hana me ka ʻole o nā palena o ka dialysis.

Hiki i kāu kauka ke ʻōlelo aku i kēia koho inā loaʻa iā ʻoe ka maʻi kīkī hope loa i hana ʻia e nā maʻi e like me ka maʻi diabetes, ke koko kiʻekiʻe, ka maʻi kīkī polycystic, a i ʻole nā maʻi autoimmune. Hoʻopōʻino mālie kēia mau maʻi i kou mau kīkī a hiki i ka hana ʻana ma lalo o 10-15% o ko lākou hiki maʻamau.

ʻO ka pōmaikaʻi nui o ka hāʻawi ola ʻana ʻo ka manawa. Ma kahi o ka kali ʻana i nā mahina a i ʻole nā makahiki ma ka papa inoa transplant, hiki iā ʻoe ke hoʻonohonoho i ke ʻoki ʻana i ka wā e olakino ana ʻoe. Hōʻike ka noiʻi i ka poʻe i loaʻa nā kīkī hāʻawi ola e ʻoi aku ka maikaʻi o nā hopena a me nā transplants lōʻihi e hoʻohālikelike ʻia me ka poʻe i loaʻa nā kīkī mai nā mea hāʻawi i make.

He aha ke kaʻina hana no ka transplant kīkī hāʻawi ola?

Hoʻopili ka transplant kīkī hāʻawi ola i ʻelua ʻoki ʻokoʻa akā ua hoʻonohonoho ʻia e hana ana i ka manawa like. Ke kālele nei ke ʻoki ʻana o kāu mea hāʻawi i ka wehe ʻana i hoʻokahi kīkī olakino, ʻoiai ʻo kāu ʻoki ʻana e pili ana i ka waiho ʻana i kēlā kīkī i loko o kou kino.

No kāu mea hāʻawi, maʻamau ka hana ʻana i 2-3 mau hola a hana pinepine ʻia me ka hoʻohana ʻana i nā ʻenehana liʻiliʻi. Hana ke kauka lapaʻau i kekahi mau ʻoki liʻiliʻi i loko o ka ʻōpū o ka mea hāʻawi a hoʻohana i kahi kamera liʻiliʻi e alakaʻi i ka wehe ʻana i ka kīkī. Ke alakaʻi nei kēia ala i ka hoʻōla wikiwiki a me ka liʻiliʻi o ka ʻeha e hoʻohālikelike ʻia me ke ʻoki hāmama kuʻuna.

Lawe kāu ʻoki ʻana ma kahi o 3-4 mau hola a pili i ka waiho ʻana i ke kīkī hou i loko o kou ʻōpū haʻahaʻa, ma ka ʻaoʻao ʻākau. ʻO ka mea e kahaha ai, waiho ʻia kou mau kīkī ponoʻī ma kahi ke ʻole lākou e hana nei i nā pilikia. Hoʻopili ʻia ke kīkī hou i nā kīʻaha koko kokoke a me kou ʻōpū, a hoʻomaka pinepine ia e hana i ka mimi.

Hana ʻia nā ʻoki ʻelua i ka haukapila hoʻokahi, pinepine i nā lumi hana e pili ana. Hoʻomaopopo kēia hoʻonohonoho ʻana i ka manawa liʻiliʻi o ka kīkī ma waho o ke kino, kahi e kōkua ai i ka mālama ʻana i kāna hana. E nānā pono ʻia ʻoe i nā wahi hoʻōla ma mua o ka neʻe ʻana i kou mau lumi haukapila.

Pehea e hoʻomākaukau ai no kāu transplant hāʻawi puʻupaʻa ola?

ʻO ka hoʻomākaukau ʻana no kāu transplant hāʻawi puʻupaʻa ola e pili ana i nā mahina he nui o nā loiloi olakino, nā hoʻololi ola, a me ka hoʻomākaukau ʻana i ka naʻau. Hoʻomaopopo kēia hana āpau e loaʻa ana ʻoe i ke kūlana maikaʻi loa no ke ʻoki a me ka hoʻōla.

E hana kāu hui lapaʻau i nā hoʻokolohua nui e loiloi i kou puʻuwai, nā māmā, ke ake, a me ke olakino holoʻokoʻa. Hiki i kēia ke komo i ka hana koko, nā kiʻi kiʻi, nā hoʻokolohua hana puʻuwai, a me nā pale ʻana i ka maʻi kanesa. E hui pū ʻoe me kahi psychologist transplant e kūkākūkā i nā ʻano manaʻo o ka loaʻa ʻana o kēia makana e hoʻololi i ke ola.

Eia nā ʻanuʻu nui e pono ai ʻoe e hana ma mua o kāu transplant:

• E hoʻopau i nā hoʻokolohua olakino a me nā manawa i koi ʻia
• E hōʻano hou i kāu mau lāʻau lapaʻau, no ka mea, ʻaʻole hiki ke hāʻawi ʻia kekahi mau lāʻau lapaʻau ma hope o ka transplant
• E hele i nā papa hoʻonaʻauao transplant e aʻo e pili ana i ka mālama ma hope o ke ʻoki
• E hoʻonohonoho i ke kākoʻo ma ka home i ka wā o kou wā hoʻōla
• E hooki i ka puhi ʻana a e kaupalena i ka inu ʻana i ka waiʻona inā pili
• E mālama i ka meaʻai maikaʻi a me ka hoʻoikaika kino e like me ka ʻae ʻia e kāu hui
• E hoʻomākaukau i kou home no ka hoʻōla ʻana me nā lako a me nā hoʻololi e pono ai

E hele ana kāu mea hāʻawi i kahi kaʻina loiloi like e hōʻoia i ke olakino lawa e hāʻawi palekana. Aia kēia i ka ʻōlelo aʻoaʻo psychological e hōʻoia i ka manawaleʻa a me ka ʻike maikaʻi ʻia o kā lākou hoʻoholo.

Pehea e heluhelu ai i kāu mau hopena transplant hāʻawi puʻupaʻa ola?

Ma hope o kāu transplant hāʻawi puʻupaʻa ola, e nānā kāu hui lapaʻau i kekahi mau hōʻailona nui e loiloi i ka maikaʻi o ka hana ʻana o kāu puʻupaʻa hou. ʻO ke ana nui loa ʻo kāu pae creatinine serum, e hōʻike ana i ka maikaʻi o ka kānana ʻana o kāu puʻupaʻa i ka ʻōpala mai kou koko.

ʻO nā pae creatinine maʻamau ma hope o ke kanu ʻana mai ka 1.0 a i ka 1.5 mg/dL, akā hiki ke loli kēia ma muli o kou nui, makahiki, a me ka nui o ka ʻiʻo. E hoʻokumu kāu kauka i kou pae kumu i nā pule ma hope o ke ʻoki ʻana, a ʻo nā hoʻonui nui paha e hōʻike ana ʻaʻole e hana maikaʻi ana kou puʻupaʻa.

ʻO nā hoʻokolohua koʻikoʻi ʻē aʻe e pili ana i kāu nitrogen urea koko (BUN), e ana ana i kekahi huahana ʻōpala, a me kāu helu kānana glomerular i manaʻo ʻia (eGFR), e manaʻo ana i ka nui o ke koko e kānana ai kou puʻupaʻa i kēlā me kēia minuke. E loaʻa nō hoʻi iā ʻoe nā hoʻokolohua mimi maʻamau e nānā i ka protein a i ʻole ke koko, hiki ke hōʻailona i nā pilikia.

E nānā pono ʻia nā pae lāʻau lapaʻau, ʻoiai ʻo kāu mau lāʻau immunosuppressive e pale ai i ka hōʻole ʻana. Pono e mālama ʻia kēia mau lāʻau lapaʻau i loko o nā pae kikoʻī e pale ai i kou puʻupaʻa hou me ka hōʻemi ʻana i nā hopena ʻaoʻao.

Pehea e mālama ai i ke olakino o kāu puʻupaʻa transplant?

ʻO ka mālama ʻana i ke olakino o kāu puʻupaʻa i kanu ʻia e koi i ka hoʻolaʻa ʻana i ke ola holoʻokoʻa i ka lawe ʻana i nā lāʻau lapaʻau, e hele ana i nā nānā maʻamau, a me ka hana ʻana i nā koho ola olakino. ʻO ka lono maikaʻi, ʻo ka hapa nui o nā kānaka e ʻike i kēia mau hana maʻamau e lilo i ke ʻano lua i ka manawa.

ʻO kāu hana nui ka lawe ʻana i kāu mau lāʻau immunosuppressive e like me ke kauoha ʻia, i kēlā me kēia lā. Pale kēia mau lāʻau i kou ʻōnaehana pale mai ka hoʻouka ʻana i kou puʻupaʻa hou, akā pono e lawe mau ʻia lākou e hana pono. Mai haʻalele i nā lāʻau a i ʻole e hooki i ka lawe ʻana iā lākou me ka ʻae ʻole o kāu kauka.

He mea nui nā manawa nānā maʻamau, ʻoiai i ka makahiki mua ma hope o ke kanu ʻana. I ka wā mua, hiki iā ʻoe ke kipa i kāu hui transplant ʻelua i ka pule, akā e emi mālie kēia i kēlā me kēia mahina, a laila i kēlā me kēia mau mahina i ka wā e paʻa ai kou puʻupaʻa. Aia i loko o kēia mau kipa nā hoʻokolohua koko, nā hoʻokolohua kino, a me nā hoʻoponopono lāʻau lapaʻau.

Eia nā ʻanuʻu koʻikoʻi e pale ai i kou puʻupaʻa i kanu ʻia:

• E lawe i nā lāʻau lapaʻau a pau e like me ke kauoha, i nā manawa like i kēlā me kēia lā
• E mālama i nā manawa hālāwai e pono ai
• E mālama i ka meaʻai olakino me nā ʻāpana kūpono a me ka sodium liʻiliʻi
• E noho ikaika kino me ka ʻae ʻia o kāu kauka
• E pale iā ʻoe iho mai nā maʻi ma o ka maʻemaʻe maikaʻi a me ka pale ʻana i nā lehulehu ke maʻi
• E ʻaʻahu i ka pale lā a me nā lole pale ma muli o ka piʻi ʻana o ka pilikia o ka maʻi kanesa
• E pale i ka launa pū ʻana me nā poʻe i loaʻa nā maʻi lele
• E hōʻike koke i nā hōʻailona a i ʻole nā hopohopo i kāu hui transplant

E hāʻawi kāu hui transplant i nā alakaʻi kikoʻī e pili ana i nā meaʻai e pale aku ai, pehea e pale ai i nā maʻi, a me ka manawa e ʻimi ai i ka lāʻau lapaʻau. ʻO ka hahai ʻana i kēia mau ʻōlelo aʻoaʻo e kōkua i ka hōʻoia ʻana e hana maikaʻi ana kāu puʻupaʻa hou no nā makahiki he nui.

He aha nā mea pilikia no nā pilikia transplant puʻupaʻa?

Hiki i kekahi mau mea ke hoʻonui i kou pilikia o nā pilikia ma hope o ka transplant puʻupaʻa mea hāʻawi ola. ʻO ka hoʻomaopopo ʻana i kēia mau pilikia e kōkua iā ʻoe a me kāu hui lapaʻau e hana i nā hana e hōʻemi iā lākou a hopu i nā pilikia i ka wā mua.

He hana ko ka makahiki, no ka mea, ʻoi aku ka nui o ka pilikia o nā mea loaʻa kahiko a me ka lohi o ka hoʻōla. Eia naʻe, ʻaʻole e hoʻokaʻawale wale ka makahiki iā ʻoe mai ka transplant inā olakino ʻoe. ʻO kou kūlana olakino holoʻokoʻa, me nā maʻi e like me ka maʻi diabetes, ka maʻi puʻuwai, a i ʻole nā ʻoki i hala, e pili pū ana i kou pae pilikia.

ʻO nā mea pilikia nui loa e pili ana:

• Diabetes a i ʻole ka mālama ʻole ʻana i ke kō koko
• Maʻi puʻuwai a i ʻole ke koko kiʻekiʻe
• Nā transplants ʻōkana i hala a i ʻole nā ʻoki he nui
• Ka momona a i ʻole nā pilikia kaumaha nui
• Mōʻaukala o ka maʻi kanesa a i ʻole kekahi mau maʻi
• Puhi a i ʻole ka hoʻohana ʻana i nā mea ʻino
• ʻAʻole maikaʻi ke kākoʻo pilikanaka a i ʻole ka hiki ʻole ke hahai i nā ʻōlelo aʻoaʻo lapaʻau
• ʻO kekahi mau mea genetic e pili ana i ka metabolism lāʻau

Ke nānā pono nei kāu hui transplant i kēia mau mea i ka wā o kāu kaʻina loiloi. Nui nā mea pilikia e hiki ke hoʻomaikaʻi ʻia ma mua o ka transplant ma o nā loli ola, ka mālama olakino maikaʻi, a i ʻole nā lāʻau lapaʻau hou.

He aha nā pilikia e hiki ke loaʻa mai ka transplant puʻupaʻa mea hāʻawi ola?

ʻOiai he kūleʻa maikaʻi ka transplant puʻupaʻa mea hāʻawi ola, he mea nui e hoʻomaopopo i nā pilikia e hiki ke loaʻa. Hiki ke mālama ʻia ka hapa nui o nā pilikia ke hopu ʻia i ka wā mua, ʻo ia ke kumu e koʻikoʻi ai ka nānā mau.

ʻO ka hopohopo nui loa, ʻo ia ka hōʻole ʻana o ka puʻupaʻa, kahi e hoʻouka ai kāu ʻōnaehana pale i ka puʻupaʻa i hoʻololi ʻia. Hiki kēia i nā makahiki ma hope o ka transplant, ʻo ia ke kumu e pono ai ʻoe e lawe i nā lāʻau immunosuppressive no ke ola. Hiki ke mālama maikaʻi ʻia ka hōʻole ʻana i ka maʻi inā ʻike ʻia i ka wā mua ma o nā hoʻokolohua koko maʻamau.

Eia nā pilikia nui e pono ai ʻoe e ʻike:

• Hōʻole ʻia o ka puʻupaʻa (acute a i ʻole chronic)
• Hoʻonui ʻia ka pilikia o nā maʻi ma muli o nā lāʻau immunosuppressive
• ʻOi aku ka nui o ka ulu ʻana i kekahi mau maʻi maʻi, ʻoi aku ka maʻi ʻili
• Nā pilikia cardiovascular me ke koko kiʻekiʻe a me ka maʻi puʻuwai
• Maʻi iwi a me ka piʻi ʻana o ka pilikia o ka haki
• Nā hopena ʻaoʻao o ka lāʻau lapaʻau me ka ʻona puʻupaʻa
• Nā pilikia ʻoki e like me ke kahe ʻana, nā koko koko, a i ʻole nā pilikia hoʻōla ʻeha
• Diabetes a i ʻole ka ʻino ʻana o ka maʻi diabetes

ʻO nā pilikia liʻiliʻi akā koʻikoʻi, ʻo ia nā maʻi koʻikoʻi, kekahi mau ʻano lymphoma, a me nā pilikia me nā kīʻaha koko i pili i kāu puʻupaʻa hou. Nānā kāu hui transplant i kēia mau mea a pau ma o ka hoʻāʻo a me nā hoʻokolokolo maʻamau.

ʻO ka nūhou maikaʻi, ʻo ka hapa nui o ka poʻe e loaʻa ana i nā puʻupaʻa mea hāʻawi ola e hana maikaʻi loa i ka wā lōʻihi. Me ka mālama kūpono a me ka nānā ʻana, hana maikaʻi nā puʻupaʻa i hoʻololi ʻia no 15-20 mau makahiki a ʻoi aku paha.

I ka manawa hea wau e ʻike ai i ke kauka ma hope o ka transplant puʻupaʻa?

Pono ʻoe e kelepona koke i kāu hui transplant inā ʻike ʻoe i nā hōʻailona e hopohopo nei ma hope o kāu transplant puʻupaʻa. ʻO ka ʻike mua ʻana a me ka mālama ʻana i nā pilikia hiki ke pale pinepine i nā pilikia koʻikoʻi a pale i kāu puʻupaʻa hou.

ʻO ke kuni kekahi o nā hōʻailona hōʻailona nui e nānā ai. ʻO kēlā me kēia mahana ma luna o 100.4°F (38°C) hiki ke hōʻike i kahi maʻi, hiki ke pilikia loa ke lawe ʻoe i nā lāʻau immunosuppressive. Mai kali e ʻike inā e hele wale ia.

E kelepona koke i kāu hui transplant inā ʻike ʻoe:

• Kuni ma luna o 100.4°F (38°C)
• Nā hōʻailona e like me ka maʻi flu me nā anu, nā ʻeha kino, a i ʻole ka luhi
• Urine i hoʻemi ʻia a i ʻole nā ​​hoʻololi i ke kala o ka mimi
• ʻO ka pehu ʻana i kou mau wāwae, nā kuʻekuʻe wāwae, a i ʻole a puni kou mau maka
• Ka loaʻa ʻana o ke kaumaha koke (ʻoi aku ma mua o 2-3 paona i ka lā)
• ʻEha a i ʻole ke aloha ma luna o kāu puʻupaʻa i hoʻololi ʻia
• Nausea, luaʻi, a i ʻole hiki ʻole ke mālama i nā lāʻau lapaʻau
• Pōkole o ka hanu a i ʻole ka ʻeha o ka umauma
• Nā poʻo koʻikoʻi a i ʻole nā ​​hoʻololi i ka ʻike
• ʻO nā puʻupuʻu hou, nā puʻupuʻu, a i ʻole nā ​​hoʻololi ʻili

Pono nō hoʻi ʻoe e hoʻopili inā he nīnau kāu e pili ana i kāu mau lāʻau lapaʻau, nā maʻi i hala, a i ʻole nā ​​hopena ʻaoʻao. Aia kāu hui transplant e kākoʻo iā ʻoe, a makemake lākou e lohe mai iā ʻoe e pili ana i nā hopohopo liʻiliʻi ma mua o ka hana ʻana me nā pilikia nui ma hope.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka transplant puʻupaʻa mea hāʻawi ola

Q.1 ʻOi aku ka maikaʻi o ka transplant puʻupaʻa mea hāʻawi ola ma mua o ka dialysis?

ʻAe, hāʻawi pinepine ka transplant puʻupaʻa mea hāʻawi ola i nā mea maikaʻi nui ma mua o ka noho ʻana ma ka dialysis no ka wā lōʻihi. ʻO ka hapa nui o nā kānaka e ʻike i ka maikaʻi o ke ola, ka ikehu nui, a me ka liʻiliʻi o nā kapu meaʻai ma hope o ka transplant kūleʻa.

Hōʻike ka noiʻi e ola lōʻihi ana ka poʻe i loaʻa i ka transplant puʻupaʻa ma mua o ka poʻe e noho ana ma ka dialysis. E loaʻa nō hoʻi iā ʻoe ke kūʻokoʻa hou aʻe e hele ai, e hana ai, a e komo ai i nā hana me ka ʻole e paʻa i ka papa hana dialysis. Eia naʻe, pono ka transplant i nā lāʻau lapaʻau no ke ola a me ka nānā mau.

Q.2 Loaʻa i ka mea hāʻawi i nā pilikia olakino lōʻihi?

ʻO ka hapa nui o nā mea hāʻawi puʻupaʻa e ola ana i ke ola maʻamau, olakino ma hope o ka hāʻawi ʻana me ka ʻole o nā pilikia olakino lōʻihi. Hōʻike nā haʻawina e pili ana i nā mea hāʻawi no nā makahiki he nui e loaʻa iā lākou ka lōʻihi o ke ola e like me ka heluna kanaka maʻamau.

Pono nā mea hāʻawi i nā nānā mau e nānā i kā lākou hana puʻupaʻa a me ke koko. I kekahi manawa, hiki i kekahi poʻe hāʻawi ke hoʻomohala i ke koko kiʻekiʻe a i ʻole ka hana puʻupaʻa i hōʻemi ʻia ma hope o ke ola, akā ʻaʻole maʻamau nā pilikia koʻikoʻi ke nānā pono ʻia nā mea hāʻawi.

Q.3 Pehea ka lōʻihi o ka puʻupaʻa mea hāʻawi ola?

ʻO ka maʻamau, hana maikaʻi nā puʻupaʻa mea hāʻawi ola no 15-20 mau makahiki a ʻoi aku paha, me kekahi e mau ana no ka lōʻihi. Aia ka lōʻihi o ke ola i nā mea e like me kou makahiki, ke olakino holoʻokoʻa, pehea ʻoe e mālama ai iā ʻoe iho, a me ka pili ʻana i kāu regimen lapaʻau.

ʻO ka maʻamau, ʻoi aku ka lōʻihi o nā puʻupaʻa mea hāʻawi ola ma mua o nā puʻupaʻa mai nā mea hāʻawi i make no ka mea ʻoi aku ka olakino e hoʻomaka ai a hoʻolilo i ka manawa liʻiliʻi ma waho o ke kino. ʻO ka lawe mau ʻana i kāu mau lāʻau lapaʻau a me ka mālama ʻana i nā hana olakino maikaʻi e kōkua i ka hoʻonui ʻana i ke ola o kāu puʻupaʻa.

Q.4 Hiki iaʻu ke loaʻa ma mua o hoʻokahi transplant puʻupaʻa?

ʻAe, hiki ke loaʻa i ka transplant puʻupaʻa ʻelua inā hāʻule kāu mea mua. Nui ka poʻe i loaʻa i ka lua a i ʻole ke kolu o ka transplant, ʻoiai ʻoi aku ka paʻakikī o kēlā me kēia transplant ma muli o ka piʻi ʻana o nā antibodies i kou koko.

E loiloi ana kāu hui transplant iā ʻoe no kekahi transplant ʻē aʻe me ka hoʻohana ʻana i nā pae hoʻohālike like me ka manawa mua. Inā he moho ʻoe, hiki iā ʻoe ke loaʻa kekahi puʻupaʻa mai kahi mea hāʻawi ola a i ʻole e kali no kekahi mai kahi mea hāʻawi i make.

Q.5 He aha ka mea e hana ai i koʻu mau puʻupaʻa mua ma hope o ka transplant?

I ka hapanui o nā hihia, waiho ʻia kou mau puʻupaʻa mua ma hope o ka transplant ke ʻole lākou e hana nei i nā pilikia kikoʻī e like me nā maʻi, ke koko kiʻekiʻe, a i ʻole ka lawe ʻana i kahi ākea nui loa. Hoʻokomo ʻia kāu puʻupaʻa hou i loko o kou ʻōpū lalo, kaʻawale mai kou mau puʻupaʻa mua.

Hiki i kou mau puʻupaʻa mua ke hoʻomau i ka hana ʻana i nā mea liʻiliʻi o ka mimi ʻoiai ma hope o ka hāʻule ʻana, a ʻo ka waiho ʻana iā lākou i kahi e hana maʻamau ʻaʻole ia e hana i nā pilikia. Eia naʻe, inā lilo lākou i pilikia, hiki ke wehe ʻia lākou i kahi ʻoki ʻokoʻa.