Chii chinonzi Deceased-Donor Kidney Transplant? Chinangwa, Maitiro & Mhedzisiro

Deceased-donor kidney transplant ndiyo kuvhiyiwa kunoponesa hupenyu kwaunogamuchira itsvo ine hutano kubva kumunhu akafa uye akabvuma kupa nhengo dzavo. Maitiro aya anopa tariro kana itsvo dzako dzisichakwanisi kusefa tsvina nemvura yakawandisa kubva muropa rako nemazvo.

Rwendo urwu runosanganisira kuenzanisa kwakanyatsoitwa pakati pako neitsvo yemunhu akapa kuti ave nechokwadi chekuwana mhedzisiro yakanaka. Kunyange zvazvo kumirira nhengo inoenderana kunogona kunzwa kusingakundiki, kunzwisisa maitiro acho kunogona kukubatsira kuti unzwe wakagadzirira uye wakavimbika pamusoro peiyi nzira yekurapa yakakosha.

Chii chinonzi deceased-donor kidney transplant?

Deceased-donor kidney transplant inotsiva itsvo yako isingashandi neimwe ine hutano kubva kune mumwe munhu akafa. Itswo yemunhu akapa inobva kune vanhu vakaita sarudzo yakanaka yekupa nhengo dzavo mushure mekufa, vachipa vamwe mukana wechipiri wehupenyu.

Itsvo yako itsva ichaiswa mudumbu rako rezasi, kazhinji kurutivi rwerudyi. Zvinoshamisa, itsvo dzako dzinowanzo gara panzvimbo pavo kunze kwekunge dzichikonzera matambudziko chaiwo. Itswo yakaiswa inobatanidza nemidziyo yeropa iri pedyo neura rako, kwaanotanga kusefa ropa rako uye kugadzira weti.

Rudzi urwu rwekuchinjisa runosiyana nekuchinjisa kwemupenyu-donor nekuti itsvo inobva kune mumwe munhu akafa. Nhengo yacho inofanira kuchengetedzwa zvakanaka uye kutakurwa nekukurumidza kuti ichengetedze basa rayo kumugamuchiri.

Nei deceased-donor kidney transplant ichiitwa?

Chiremba wako anokurudzira kuchinjisa uku kana itsvo dzako dzisingachakwanisi kukuchengeta uine hutano wega. Chirwere cheitsvo chekupedzisira zvinoreva kuti itsvo dzako dzinoshanda pazasi pe10% yemukana wavo wenguva dzose, zvichiita kuti dialysis kana kuchinjisa zvive zvakakosha kuti upenyu hurambe huripo.

Zvirwere zvakawanda zvinogona kutungamira kunzvimbo iyi, uye kuzvinzwisisa kunobatsira kutsanangura nei kutapurirana kunova sarudzo yakanakisisa. Zvikonzero zvakajairika zvinosanganisira:

• Kukuvadzwa kwematsvo kunokonzerwa nechirwere cheshuga (diabetic nephropathy)
• Kuvhunduka kweropa kwakanyanya kunokonzera mavanga ematsvo
• Chirwere chemapfupa ematsvo chine matsvo akakura, akazadzwa nematsvo
• Glomerulonephritis, iyo inokuvadza zvikamu zvekunatsa zveitsvo
• Zvirwere zvemuviri zvekuzvidzivirira zvakadai se lupus zvichikanganisa basa reitsvo
• Zvirwere zveitsvo zvakagarwa nhaka zviripo kubva pakuzvarwa
• Kukuvadzwa kwematsvo kubva kumishonga kana chepfu

Kutapurirana kunobudirira kazhinji kunopa hupenyu huri nani pane dialysis yenguva refu. Vanhu vazhinji vanonzwa vane simba uye vanogona kudzokera kuzviitiko zvavaifarira chirwere cheitsvo chisati chafambira mberi.

Ndeipi nzira yekutapurirana itsvo kubva kumupi akashaika?

Kuvhiyiwa kwekutapurirana kunowanzo tora maawa matatu kusvika ku4 uye kunoitika senzira yekukurumidzira kana itsvo inoenderana yawanikwa. Iwe uchagamuchira general anesthesia, saka iwe uchavata zvachose panguva yekuvhiya.

Chiremba wako anogadzira incision mudumbu rako rezasi kuti awane nzvimbo iyo itsvo yako itsva ichaiswa. Maitiro acho anosanganisira matanho akati wandei ekuchenjerera kuti ave nechokwadi chekubuda kwakanaka:

1. Chiremba anaisa itsvo yemupi mudumbu rako rezasi rekurudyi
2. Midzi yeropa kubva kuitsvo itsva inobatanidza kumidzi yako yeropa iripo
3. Ureter yeitsvo (tubhu rinotakura weti) rinonamatira kubladder yako
4. Chiremba wako anoedza zvinobatanidza kuti ave nechokwadi chekuyerera kweropa kwakakodzera
5. Incision inovharwa nemasutures kana staples

Itsvo itsva kazhinji inotanga kugadzira weti nekukasira, kunyangwe dzimwe nguva zvinotora mazuva kana mavhiki kuti itange kushanda zvizere. Chikwata chako chekurapa chinokutarisa zvakanyanya panguva ino yakakosha kuti uve nechokwadi chekuti zvese zvinoshanda nemazvo.

Maitiro ekugadzirira kutapurirana itsvo yako kubva kumupi akashaika?

Kugadzirira kutapurirana kunosanganisira kuisa zita rako pane runyora rwekumirira uye kugara wakagadzirira kufonerwa kana itsvo yawanikwa. Maitiro ekuongorora anoona kuti une hutano hwakakwana hwekuvhiyiwa uye unogona kubatsirwa nekutapurirana.

Chikwata chako chekutapurirana chichakutungamira kuburikidza nekuongorora kwakazara kunoongorora hutano hwako hwese. Iyi nhanho yekugadzirira inowanzo sanganisira:

• Miedzo yeropa yekutarisa mashandiro emuviri uye mamiriro ekutapukirwa
• Miedzo yemoyo senge EKG uye echocardiogram
• Miedzo yemabasa emapapu uye X-rays yechipfuva
• Kutsvaga kenza kwakakodzera zera rako
• Kuongororwa kwemazino kuti uone chero zvirwere
• Kuongororwa kwepfungwa kuti uone kugadzirira
• Kupa mazano emari pamusoro pemitengo yekutapurirana

Kana wangobvumidzwa, uchabatana nerunyorwa rwemirairo rwenyika kuburikidza neUnited Network for Organ Sharing (UNOS). Gara uchisvikika nguva dzese nekuti uchafanirwa kuenda kuchipatara mukati meawa ekugamuchira runhare.

Chengeta hutano hwako hwakagadzikana sezvinobvira uchimirira. Ramba uchirapwa nedialysis, tora mishonga yakarairwa, uye chengeta chikafu chakanaka kuti uve mumamiriro akanaka ekuvhiyiwa kana mukana wasvika.

Maitiro ekuverenga mhedzisiro yako yekutapurirana itsvo?

Mushure mekutapurirana, chikwata chako chekurapa chinoongorora miedzo yeropa yakatarwa kuti chitarise kuti itsvo yako itsva iri kushanda sei. Chiyero chakakosha ndicho chiyero chako checreatinine, icho chinofanira kudzikira zvakanyanya zvichienzaniswa nekutapurirana usati wava nani basa reitsvo yako.

Vanachiremba vako vanoteedzera zviyero zvakawanda zvakakosha kuti vaone kuti kutapurirana kwako kunoramba kuri hutano. Miedzo iyi inobatsira kuona chero matambudziko kare apo anonyanya kurapika:

• Mazinga eCreatinine (anofanira kunge ari 0.6-1.2 mg/dL mumatsvo ane hutano)
• Blood urea nitrogen (BUN) inoratidza kubviswa kwemarara
• Glomerular filtration rate (GFR) kuyera chikamu chebasa rematsvo
• Mazinga eprotein mumiyedzo yeweti
• Mazinga emishonga inodzvinyirira immune system muropa rako

Mhedzisiro yakajairika inosiyana kubva kumunhu nemunhu, uye itsvo yako itsva inogona kusashanda zvakafanana netsvo ine hutano. Chikwata chako chekutapurirana chichatsanangura kuti nhamba dzipi dzakakodzera mamiriro ako chaiwo uye kugadzirisa mishonga zvinoenderana.

Nzira yekuchengetedza itsvo yako yakaiswa?

Kudzivirira itsvo yako itsva kunoda kuzvipira kweupenyu hwese kumishonga uye kusarudza mararamiro ane hutano. Immune system yako inoda kuramba nhengo yakaiswa, saka mishonga inodzvinyirira immune system yakakosha kudzivirira kurambwa uku.

Kutora mishonga sezvakarairwa ndicho chinhu chakakosha chaunogona kuita pakutapurirana kwako. Mishonga iyi ine simba inoda kunyatsoongororwa nekuti inokanganisa immune system yako yese:

• Mishonga inorwisa kurambwa inotorwa panguva imwe chete zuva rega rega
• Mishonga yekudzikisa BP kudzivirira basa rematsvo
• Mishonga yekudzivirira zvirwere uye chirwere chemapfupa
• Miyedzo yeropa yenguva dzose yekutarisa mazinga emishonga

Kusarudza mararamiro ane hutano kunotsigira kubudirira kwenguva refu kwekutapurirana kwako. Izvi zvinosanganisira kudya chikafu chakaringana, kurovedza muviri nguva dzose sezvakatenderwa nachiremba wako, kudzivirira kusangana nezvirwere, uye kudzivirira ganda rako kubva mukukuvadzwa nezuva sezvo mishonga inodzvinyirira immune system inowedzera njodzi yekenza.

Chii chinonyanya kubuda mushure mekuiswa kwematsvo?

Mhedzisiro yakanaka zvikuru zvinoreva kuti itsvo yako itsva inoshanda zvakanaka kwemakore mazhinji, zvichikubvumira kuti urarame hupenyu hunoshingaira, hunozadzisa. Vanhu vazhinji vanonzwa zviri nani zvakanyanya kupfuura zvavakaita pa dialysis, vane simba rakawanda uye rusununguko mumabasa avo emazuva ese.

Mabasa ekubudirira ekuchinjirwa itsvo kubva kumupi akashaika anokurudzira, kunyangwe mhedzisiro yemunhu mumwe nemumwe ichisiyana. Anenge 95% yeitsvo dzakachinjirwa dzinobasa zvakanaka kwegore rekutanga, uye anenge 85% anoenderera mberi achishanda mushure memakore mashanu.

Kubudirira kwenguva refu kunoenderana nezvinhu zvakawanda zvinosanganisira zera rako, hutano hwako hwese, maitiro ako ekutevera mirairo yekurapa, uye kuti itsvo yemupi inoenderana sei nerudzi rwetishu rako. Vanhu vazhinji vanodzoka kubasa, kufamba, kurovedza muviri, uye vanonakidzwa nezvinhu zvakanga zvakaoma panguva yekurwara kwetsvo kwepamberi.

Kutarisirwa nguva dzose nechirongwa chako chekuchinjirwa kunobatsira kuchengetedza mhedzisiro iyi yakanaka. Kuona nekukurumidza nekurapa matambudziko chero api zvayo kunogona kudzivirira matambudziko akakomba uye kubatsira kuchengetedza basa reitsvo yako kwemakumi emakore.

Ndezvipi zvinhu zvine njodzi zvematambudziko ekuchinjirwa itsvo?

Zvimwe zvinhu zvinogona kuwedzera njodzi yako yematambudziko mushure mekuisa, kunyangwe zvakawanda zvichigoneka nekutarisirwa kwakakodzera. Kunzwisisa njodzi idzi kunobatsira iwe nechikwata chako chekurapa kushanda pamwechete kuderedza matambudziko.

Zvimwe zvinhu zvine njodzi zvausingakwanise kuchinja, nepo vamwe vachipindura kune shanduko yehupenyu uye kutarisirwa kwekurapa kwakanyatso. Zvinhu zvikuru zvinokanganisa mhedzisiro yekuchinjirwa zvinosanganisira:

• Zera (vagamuchiri vakuru vanotarisana nemitengo yakakwira yematambudziko)
• Chirwere cheshuga kana chirwere chemoyo chiripo pamberi pekuisa
• Kuiswa kwepamberi kana kuwedzerwa kweropa
• Mazinga epamusoro emaantibodies muropa rako
• Kusatevedzera mishonga mushure mekuisa
• Kusvuta kana kushandisa doro zvakanyanya
• Kufutisa kunokanganisa kupora kwekuvhiya

Chikwata chako chekuchinjirwa chinoongorora zvinhu izvi panguva yekuvheneka uye chinoshanda newe kuti uwedzere hutano hwako pamberi pekuvhiya. Zvinhu zvakawanda zvine njodzi zvinogona kuvandudzwa kuburikidza nekuchinja mararamiro, kugadzirisa mishonga, kana mamwe marapirwo ekurapa.

Zviri nani here kuva nekuisa itsvo pane kuramba uri pa dialysis?

Kune vanhu vazhinji vane chirwere cheitsvo chekupedzisira, kutamiswa kweitsvo kunopa zvakanakira zvakanyanya kupfuura dialysis yenguva refu. Zvidzidzo zvinoratidza nguva dzose kuti vanhu vakagamuchira kutamiswa kweitsvo vanowanzo rarama kwenguva refu uye vanonakidzwa nehutano huri nani hwehupenyu kupfuura avo vanoramba vachidialysis.

Zvakabatsira zvinopfuura kungoti nhamba dzekupona. Vanhu vazhinji vanowana kutamiswa kweitsvo kuchivabvumira kuti vanzwe vakaita sevavo zvakare, vaine simba rakawedzerwa uye zvishoma zvekudya zvinodiwa kupfuura dialysis.

Zvisinei, kutamiswa kweitsvo hakusi kwemunhu wese. Vamwe vanhu vane chirwere chemoyo chakakomba, kenza inoshanda, kana zvimwe zvinetso zvakakura zvehutano vangaita zviri nani vachiramba vachidialysis. Chikwata chako chekutamiswa kweitsvo chinonyatsoongorora kana iwe uchizobatsirwa nekuvhiyiwa kwekutamiswa kweitsvo.

Sarudzo inosanganisira kuyera njodzi dzekuvhiya pamwe chete nezvakanakira zvinogona kuitika. Kunyange kutamiswa kweitsvo kuchida mishonga yekudzivirira immune yehupenyu hwese ine njodzi dzayo, vanhu vazhinji vanowana iyi yekutengeserana yakakosha yehutano huri nani hwehupenyu.

Ndezvipi zvinetso zvinogona kuitika zvekutamiswa kweitsvo?

Kufanana nekuvhiyiwa kukuru kupi zvako, kutamiswa kweitsvo kunotakura njodzi dzese dzenguva pfupi nedzenguva refu. Kunzwisisa izvi zvinogoneka kunokubatsira kuziva zviratidzo zvekuyambira uye kutsvaga rubatsiro rwekurapa nekukurumidza kana zvichidikanwa.

Zvinetso zvekutanga zvinogona kuitika mumavhiki mashoma ekutanga mushure mekuvhiyiwa, nepo dzimwe nyaya dzinogona kukura mwedzi kana makore gare gare. Hezvino zvinonyanya kukosha zvinotarisa chikwata chako chekurapa:

• Kurambwa kwakanyanya uko immune system yako inorwisa itsvo itsva
• Zvirwere nekuda kwemishonga yekudzivirira immune
• Mavhiri eropa mumidziyo yeropa yeitsvo
• Zvirwere zvegumbo remvura kana kuvharika
• Matambudziko ekupora kwemaronda panzvimbo yekuvhiya
• Mhedzisiro kubva kumishonga yekurwisa kurambwa
• Kuwedzera njodzi yekenza kubva pakudzivirirwa kweimmune
• Kuenderera mberi kwechirwere chemoyo

Matambudziko mazhinji anogona kurapwa kana akabatwa nekukurumidza, ndosaka kusangana nguva dzose kuchikosha. Chikwata chako chekutapurirana chinokudzidzisa zviratidzo zvekuchenjerera zvekutarisa uye chinopa ruzivo rwekubata rweawa makumi maviri nemana kana paine zvinokunetsa zvinokurumidza.

Matambudziko enguva refu angasanganisire kurambwa kusingaperi, uko itsvo inorasikirwa zvishoma nezvishoma basa rayo kwemakore, kana mhedzisiro kubva kumishonga yakaita sechirwere chemapfupa kana kuwedzera njodzi yekutapukirwa. Kuongorora nguva dzose kunobatsira kuona nekugadzirisa nyaya idzi vasati vava vakakomba.

Ndingafanira kuona chiremba riini mushure mekutapurirana itsvo?

Unofanira kubata chikwata chako chekutapurirana nekukurumidza kana ukaona chero zviratidzo zvinokunetsa mushure mekutapurirana kwako. Kutariswa kwekurapa nekukurumidza kunogona kudzivirira matambudziko madiki kubva pakuva matambudziko akakomba.

Zvimwe zviratidzo zvinoda kuongororwa kwekurapa nekukurumidza nekuti zvinogona kuratidza kurambwa kana kutapukirwa kwakakomba. Usazeza kufonera murongi wako wekutapurirana kana kuenda kukamuri rekukurumidzira kana ukaona:

• Fivha inodarika 100.4°F (38°C) kana kutonhora
• Kuderera kwemvura yeweti kana shanduko mumavara eweti
• Kuzvimba mumakumbo, zvitsitsinho, kana kutenderedza maziso
• Kuwedzera uremu kusingatsanangurwi (kupfuura mapaundi matatu mumazuva maviri)
• Kurwadziwa kana kunzwira tsitsi panzvimbo yekutapurirana
• Nyonganyonga yakakomba, kurutsa, kana manyoka
• Kufema kwakaoma kana kurwadziwa muchipfuva
• Kurwadziwa kwemusoro kwakanyanya kana shanduko dzekuona

Kusangana kwakarongeka nguva dzose kwakakoshawo pakuongorora hutano hwekutapurirana kwako. Kushanya uku kunowanzoitika kakawanda pakutanga, wobva wapararira zvishoma nezvishoma sezvo kupora kwako kuchifambira mberi uye itsvo yako itsva inoramba yakagadzikana.

Chikwata chako chekutapurirana chinova shamwari yako yenguva refu yekurapa, saka chengeta kutaurirana kwakavhurika nezve chero zvinokunetsa zvehutano, mhedzisiro yemishonga, kana shanduko mukuona kwako. Kupindira nekukurumidza kunowanzo kudzivirira nyaya diki kubva pakuva matambudziko makuru.

Mibvunzo inowanzo bvunzwa nezve kutapurirana itsvo kubva kumupi wechipo akafa

Mubvunzo 1: Kuisa itsvo kubva kumupi akashaika kuri nani pane kuisa itsvo kubva kumupi mupenyu?

Itsvo dzinobva kumupi mupenyu dzinowanzo gara kwenguva refu uye dzinotadza zviri nani pane itsvo dzinobva kumupi akashaika, asi ese ari maviri anogona kuponesa hupenyu. Itsvo dzinobva kumupi mupenyu dzinowanzo tanga kushanda nekukasira uye dzinogona kushanda kwemakore 20-25, nepo itsvo dzinobva kumupi akashaika dzichishanda avhareji yemakore 15-20.

Zvisinei, kuisa itsvo kubva kumupi akashaika kunoramba kuri sarudzo yakanaka kana vapi vasingawanikwi. Chinhu chakanyanya kukosha ndechokugamuchira kuisa itsvo panzvimbo yerudzi rwakati rwemupi, sezvo zvese zviri zviviri zvichivandudza zvikuru kupona uye mhando yehupenyu zvichienzaniswa nekufamba kwenguva dialysis.

Mubvunzo 2: Kumirira kwenguva refu kuisa itsvo kunokanganisa mhedzisiro here?

Nguva refu yekumirira inogona kukanganisa kubudirira kwekuisa itsvo, kunyanya kana hutano hwako huchinyanya kuipa uchimirira. Vanhu vanogamuchira kuisa itsvo vasati vatanga dialysis kana nguva pfupi mushure mekutanga dialysis vanowanzoita mhedzisiro iri nani pane avo vanomirira makore mazhinji.

Zvisinei, kugamuchira itsvo yakanyatsoenderana zvakare kwakakosha kubudirira kwenguva refu. Chikwata chako chekuisa itsvo chinoyera izvi zvinhu pakufunga nezve itsvo, dzimwe nguva chichikurudzira kumirira zvakanyanya kana hutano hwako huchiramba hwakagadzikana.

Mubvunzo 3: Ndingava nevana mushure mekuisa itsvo here?

Vakadzi vazhinji vanobudirira vane pamuviri une hutano mushure mekuisa itsvo, kunyangwe zvichida kuronga nekuchenjerera uye kuongorora. Unofanira kumirira kanenge gore rimwe mushure mekuisa itsvo usati wava nepamuviri kuti uve nechokwadi chokuti basa reitsvo rako rakagadzikana.

Kuzvitakura mushure mekuisa itsvo kunoonekwa sekuisa njodzi uye kunoda kutarisirwa kwakakosha kubva kuchikwata chako chekuisa itsvo uye nyanzvi dzekuzvitakura dzine njodzi huru. Mamwe mishonga yekudzivirira immune inogona kuda kugadziriswa, uye iwe uchada kuongororwa kakawanda panguva yekuzvitakura.

Mubvunzo 4: Ndingararama kwenguva yakareba sei neitsvo yakaendeswa?

Vanhu vazhinji vanorarama makore 20-30 kana kupfuura neitsvo yakaiswa, uye dzimwe itsvo dzinofamba zvakanaka kwemakore anopfuura 40. Zvabuda zvako zvinoenderana nezvinhu zvakaita sezera rako, hutano hwako hwese, kutevedzera mishonga, uye kuti muviri wako unogamuchira sei itsvo itsva.

Hafu yeitsvo dzemupi akashaika dzinoramba dzichishanda mushure memakore 15-20, nepo vanhu vazhinji vanogamuchira vachirarama hupenyu hwakajairika nemitezo yavo yakaiswa. Kufambira mberi mumishonga yekudzivirira immune system uye kutarisirwa kwekuisa itsvo kunoramba kuchivandudza zvabuda kwenguva refu.

Q.5 Chii chinoitika kana itsvo yangu yakaiswa ikakundikana?

Kana itsvo yako yakaiswa ikakundikana, unogona kudzokera ku dialysis uye pamwe kugamuchira imwe transplant. Vanhu vazhinji vanobudirira kugamuchira transplants yechipiri kana kunyange yechitatu yetsvo, kunyangwe transplant yega yega inogona kuve yakaoma nekuda kwekuwedzera kwehuwandu hwemuviri.

Chikwata chako chekuisa itsvo chinotarisa basa reitsvo yako zvakanyanya kuti zviwane matambudziko nekukurumidza apo kurapwa kunogona kuchengetedza basa kwenguva refu. Kana kukundikana kwekuisa itsvo kwave kusingadzivisiki, vachakubatsira kuchinjira kumashure ku dialysis uye kukutora kuti uongororwe imwe transplant kana zvakakodzera.