Yini i-Donor Nephrectomy? Inhloso, Inqubo & Ukululama

I-Donor nephrectomy iyinqubo yokuhlinzwa lapho kususwa khona izinso eyodwa enempilo kumuntu ophilayo ukuze ifakwe komunye onokwehluleka kwezinso. Lokhu kuhlinzwa okusindisa impilo kukuvumela ukuthi usize othile ukuthi abuyisele impilo yabo ngenkathi usaphila impilo ejwayelekile ngokuphelele ngesinso sakho esisele.

Ukunikelwa ngezinso eziphilayo kumelela esinye sezenzo zomusa kakhulu emithini. Isinso sakho esisodwa esinempilo singasebenza kahle njengezinso ezimbili kubantu abaningi, okwenza le nqubo iphephe futhi ibaluleke ngendlela emangalisayo.

Yini i-donor nephrectomy?

I-Donor nephrectomy ukususwa ngokuhlinzwa kwesinso esinempilo esivela kumnikeli ophilayo ukuze kufakwe. Le nqubo ngokuvamile ithatha amahora angu-2-4 futhi ingenziwa kusetshenziswa izindlela ezingahlaseli kakhulu.

Ngesikhathi sokuhlinzwa, udokotela ohlinzayo uzosusa ngokucophelela isinso esisodwa ngenkathi egcina zonke izakhiwo ezizungezile. Isinso sakho esisele ngokwemvelo sizojwayela ukubhekana nomsebenzi ogcwele, ngokuvamile kungakapheli amasonto ambalwa ngemva kokuhlinzwa.

Iningi le-donor nephrectomies namuhla lisebenzisa izindlela ze-laparoscopic, okusho ukusikeka okuncane nezikhathi zokululama ngokushesha. Le ndlela yenze ukunikelwa ngezinso kwaba lula kakhulu kunokuhlinzwa okuvulekile kwendabuko.

Kungani kwenziwa i-donor nephrectomy?

I-Donor nephrectomy yenziwa ukuze kunikezwe isinso esinempilo kumuntu onesifo sezinso esiphelile. Izinso zomnikeli eziphilayo ngokuvamile zisebenza kangcono futhi zihlala isikhathi eside kunezinsini ezivela kubanikeli abashonile.

Abantu abaningi bakhetha ukunikela ngoba bafuna ukusiza ilungu lomndeni, umngane, noma ngisho nomuntu ongaziwa ukuthi agweme i-dialysis noma athuthukise izinga lempilo yabo. Ovamukelayo uvame ukuzwa ngokushesha ukuthuthuka empilweni yabo kanye namazinga amandla.

Ukunikelwa okuphilayo futhi kuvumela ukuhlinzwa okuhleliwe ngesikhathi esifanele somnikeli nomamukeli. Lokhu kuguquguquka kwesikhathi kuvame ukuholela emiphumeleni engcono uma kuqhathaniswa nokulinda isinso somnikeli oshonile.

Yini inqubo ye-donor nephrectomy?

Inqubo ye-donor nephrectomy iqala nge-anesthesia ejwayelekile ukuqinisekisa ukunethezeka kwakho okuphelele ngesikhathi sokuhlinzwa. Ithimba lakho lokuhlinza lizokuqapha eduze ngesikhathi sonke senqubo.

Nakhu okwenzekayo ngesikhathi sokuhlinzwa, isinyathelo ngesinyathelo:

1. Kwenziwa ukusikeka okuncane esiswini sakho ngezinsimbi ze-laparoscopic
2. Igesi ye-carbon dioxide isetshenziselwa ukudala isikhala sokuthi udokotela ohlinzayo asebenze ngokuphepha
3. Izinso zihlukaniswa ngokucophelela ezicutshini eziqhelene nemithambo yegazi
4. Imithambo yegazi kanye ne-ureter ivalwa futhi inqunywe ngokunembile
5. Izinso zifakwa esikhwameni esivikelayo futhi zikhishwe ngokusebenzisa ukusikeka okuncane
6. Konke ukusikeka kuvalwa ngama-sutures noma i-glue yokuhlinza

Izinso ezisusiwe zilungiswa ngokushesha futhi zifakelwe umamukeli, ngokuvamile ekamelweni lokuhlinza eliseduze. Lokhu kushintsha okusheshayo kusiza ukuqinisekisa umphumela ongcono kakhulu kini nobabili.

I-Laparoscopic vs. Ukuhlinzwa Okusemhlophe

Iningi le-donor nephrectomies manje lenziwa nge-laparoscopically, okusho ukusebenzisa ukusikeka okuncane nekhamera ukuqondisa ukuhlinzwa. Le ndlela ngokuvamile ibangela ubuhlungu obuncane, ukuhlala esibhedlela okufushane, nokululama okusheshayo.

Ukuhlinzwa okuvulekile kungase kunconywe ezimweni ezithile, njengalapho izici ze-anatomical zenza ukuhlinzwa kwe-laparoscopic kube yinselele. Udokotela wakho ohlinzayo uzoxoxa ngendlela engcono kakhulu yesimo sakho esithile ngesikhathi sokuhlolwa kwakho.

Ungalungiselela kanjani i-donor nephrectomy yakho?

Ukulungiselela i-donor nephrectomy kuhilela ukuhlolwa okubanzi kwezokwelapha ukuqinisekisa ukuthi unempilo ngokwanele ukuhlinzwa nokunikela. Le nqubo yokuhlola ngokuvamile ithatha amasonto amaningana ukuqedela.

Ukulungiselela kwakho kuzohlanganisa ukuhlolwa kwegazi, izifundo zokucabanga, kanye nemihlangano namalungu ahlukahlukene eqembu lezempilo. Uzothola futhi imininingwane enemininingwane yokuthi okulindeleke ngaphambi, ngesikhathi, nangemva kokuhlinzwa.

Nawa amanyathelo abalulekile okulungiselela okudingeka ukuwaqedela:

• Qedela umlando wezokwelapha nokuhlolwa komzimba
• Ukuhlolwa kwegazi ukuhlola ukusebenza kwezinso, uhlobo lwegazi, nempilo yonke
• Izifundo zokucabanga njenge-CT scans ukuhlola i-anatomy yakho yezinso
• Ukuhlolwa kwengqondo ukuqinisekisa ukuthi ulungele ngokomzwelo
• Ukuhlangana nethimba lokufakelwa ukuze kuxoxwe ngobungozi nezinzuzo
• Ukubonisana ngezimali ukuze uqonde noma yiziphi izindleko ezihilelekile

Uzodinga futhi ukuhlela ukuthi othile akuqhubele ekhaya ngemva kokuhlinzwa futhi akusize ezinsukwini ezimbalwa zokuqala zokululama. Ukuba nalesi simiso sokusekela endaweni kwenza ukululama kwakho kube bushelelezi kakhulu.

Imiyalo Yangaphambi Kokuhlinzwa

Ezinsukwini eziholayo ngaphambi kokuhlinzwa kwakho, uzothola imiyalelo ethile mayelana nokudla, ukuphuza, kanye nemithi. Ukulandela lezi ziqondiso ngokucophelela kusiza ekuqinisekiseni ukuhlinzwa okuphephe kakhulu.

Ngokuvamile uzodinga ukuyeka ukudla nokuphuza ngemva kwamabili ngaphambi kosuku lwakho lokuhlinzwa. Ithimba lakho lezempilo lizokunikeza umugqa wesikhathi onemininingwane wokuthi wenzeni nokuthi nini.

Ungawafunda kanjani imiphumela yakho ye-nephrectomy yomnikeli?

Ngemva kwe-nephrectomy yomnikeli, impumelelo yakho yokuhlinzwa ilinganiswa inqubekela phambili yakho yokululama nokusebenza kwesinso sakho esisele. Ithimba lakho lezempilo lizoqapha izinkomba ezimbalwa ezibalulekile ukuze liqinisekise ukuthi konke kuyelapha kahle.

Ukusebenza kwakho kwezinso kuzohlolwa ngokuhlolwa kwegazi elilinganisa amazinga e-creatinine. La mazinga angase abe phezulu kancane kunangaphambi kokuhlinzwa, kodwa lokhu kujwayelekile ngokuphelele futhi kulindelekile ngesinso esisodwa.

Nakhu okuzoqashwa yithimba lakho lezempilo ngesikhathi sokululama:

• Amazinga e-creatinine yegazi ukuhlola ukusebenza kwezinso
• Izilinganiso zomfutho wegazi ukuze kuqinisekiswe ukuzinza
• Ukuphuma komchamo ukuze kuqinisekiswe ukusebenza okuvamile kwezinso
• Ukuphulukiswa kwesilonda ezindaweni zokunquma
• Amazinga obuhlungu nokunethezeka okuphelele
• Ukubuyela emisebenzini evamile namazinga wamandla

Abaningi abanikeli babona ukusebenza kwabo kwezinso kuzinzile emasontweni ambalwa ngemva kokuhlinzwa. Inso yakho esele izothatha umsebenzi ogcwele kancane kancane, futhi uzozizwa unamandla ngokwengeziwe njengoba ululama.

Ungayigcina kanjani impilo enhle ngemuva kokususwa kwenhliziyo yomnikeli?

Ukugcina impilo yakho ngemuva kokususwa kwenhliziyo yomnikeli kuhilela ukulandela izincomo zokuphila okunempilo ezizuzisa wonke umuntu. Inso yakho esele ingakwazi ukuphatha imisebenzi ejwayelekile yempilo ngaphandle kwanoma yimiphi imikhawulo ekhethekile.

Uzodinga ukuhlolwa njalo ukuqapha ukusebenza kwezinso zakho, ngokuvamile okuvame kakhulu ngonyaka wokuqala ngemuva kokunikela. Lokhu kuvakasha kusiza ukuqinisekisa ukuthi inso yakho ihlala inempilo futhi ibambe noma yiziphi izinto ezikhathazayo kusenesikhathi.

Nazi izindlela ezibalulekile zokusekela impilo yakho yesikhathi eside:

• Hlala unamanzi ngokwanele ngokuphuza amanzi amaningi usuku lonke
• Gcina ukudla okunomsoco okunokudla kwamaprotheni okulinganiselwe
• Zivocavo njalo ukuze usekele impilo yonke yenhliziyo nemithambo yegazi
• Gcina umfutho wegazi ebangeni elinempilo
• Gwema ukubhema futhi unciphise ukusetshenziswa kotshwala
• Thatha imithi njengoba kunqunyiwe futhi ugweme imithi ebuhlungu engadingekile

Abaningi abanikeli bezinso baphila impilo ejwayelekile ngokuphelele ngaphandle kwemikhawulo yokudla noma imikhawulo yomsebenzi. Inso yakho esele ikwazi ngokugcwele ukusekela zonke izidingo zomzimba wakho.

Yiziphi izici eziyingozi zezinkinga zokususwa kwenhliziyo yomnikeli?

Ngenkathi ukususwa kwenhliziyo yomnikeli kuvamile ukuthi kuphephe kakhulu, izici ezithile zingakhuphula kancane ingozi yakho yezinkinga. Ukuqonda lezi zici kukusiza wena nethimba lakho lezempilo ukuthi nenze izinqumo ezingcono kakhulu mayelana nokunakekelwa kwakho.

Ubudala, isimo sempilo esiphelele, kanye ne-anatomy yezinso konke kunendima ekunqumeni izinga lakho eliyingozi. Ithimba lakho lokufakelwa izitho lizohlola ngokucophelela lezi zici ngesikhathi senqubo yakho yokuhlola umnikeli.

Izici eziyingozi ezivamile ezingase zikhuphule izinkinga zihlanganisa:

• Ubudala obuthuthukile (yize abantu abadala abaningi abanempilo benikela ngempumelelo)
• Ukukhuluphala noma isisindo somzimba esiphakeme kakhulu
• Umfutho wegazi ophezulu noma isifo sikashukela
• Ukuhlinzwa kwesisu kwangaphambilini okudala izicubu ezinamanxeba
• Ukuma okungajwayelekile kwezinso noma ukwehluka kwemithambo yegazi
• Ukubhema noma okunye ukusetshenziswa kukagwayi

Noma ngabe unezinye izici eziyingozi, usengaba ngumuntu omuhle kakhulu ongumnikeli. Ithimba lakho lokunakekelwa kwezempilo lizosebenza nawe ukuthuthukisa impilo yakho ngaphambi kokuhlinzwa futhi linciphise noma yiziphi izingozi ezingaba khona.

Izici Eziyingozi Ezingavamile

Ezinye izici ezingavamile zingase futhi zithinte ukufaneleka kwakho ukunikela. Lokhu kufaka phakathi izimo ezithile zofuzo, izifo ze-autoimmune, noma umlando womndeni wesifo sezinso.

Ukuhlolwa kwakho kuzofaka ukuhlolwa kwalezi zimo ezingavamile ukuqinisekisa ukuthi ukunikela kuphephile kuwe isikhathi eside. Umgomo uhlala ukugcina impilo yakho ngenkathi usiza omunye umuntu.

Ziyini izinkinga ezingaba khona ze-nephrectomy yomnikeli?

Izinkinga ze-nephrectomy yomnikeli azivamile, kodwa kubalulekile ukuqonda ukuthi yini engenzeka ukuze ukwazi ukwenza isinqumo esinolwazi. Abanikeli abaningi bathola ukululama okubushelelezi ngaphandle kwezinkinga ezinkulu.

Izinkinga zokuhlinzwa zingahlukaniswa zibe izinkinga ngemuva kokuhlinzwa ngokushesha kanye nezinkinga zesikhathi eside. Ithimba lakho lokunakekelwa kwezempilo lizokuqapha ngokucophelela nganoma yiziphi izimpawu zezinkinga ngesikhathi sokululama kwakho.

Nawa ama-complications angaba khona ngokushesha:

• Ukuphuma kwegazi endaweni yokuhlinzwa okudinga ukwelashwa okwengeziwe
• Ukutheleleka ezindaweni zokuhlinzwa noma ukutheleleka kwangaphakathi
• Amaqhubu egazi emilenzeni noma emaphashini
• Ukuphendula ku-anesthesia noma imithi
• Ukwelashwa kwezitho eziseduze ngesikhathi sokuhlinzwa
• Ukuguqulwa kusuka ku-laparoscopic kuya ekuhlinzweni okuvulekile uma kudingeka

Lezi zinkinga ezisheshayo zenzeka ngaphansi kuka-5% we-nephrectomies yomnikeli. Uma zenzeka, zivame ukulawuleka ngokunakekelwa kwezokwelapha okusheshayo.

Izinkinga zesikhathi eside

Izinkinga zesikhathi eside ngemva kokususwa kwesinye sezintso somnikeli azivamile, kodwa zingabandakanya ukwanda okuncane kwengozi yegazi eliphezulu noma amatshe ezinso. Ukunakekelwa okuvamile kokulandela ngemuva kusiza ukuthola nokuphatha lezi zinkinga ekuqaleni.

Abanye abanikeli bangase bahlangabezane nobuhlungu obungapheli ezindaweni zokuhlinzwa, nakuba lokhu kungavamile ngamasu okuhlinza anamuhla. Imiphumela eminingi yesikhathi eside imincane futhi ayinayo imithelela ebalulekile ekhwalithi yempilo.

Ngezikhathi ezingavamile, abanikeli bangase bathuthukise isifo sezinso esinsweni labo elisele eminyakeni noma emashumini eminyaka kamuva. Nokho, le ngozi iphakeme kancane kunezokujwayelekile futhi ivame ukuhlobana nezinye izinto zempilo.

Kufanele ngibone nini udokotela ngemva kokususwa kwesinye sezintso somnikeli?

Kufanele uthinte ithimba lakho lezempilo ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezikhathazayo ngemva kokususwa kwesinye sezintso somnikeli. Ukungenelela ngokushesha kungavimbela izinkinga ezincane ukuthi zingabi izinkinga ezinkulu.

Ithimba lakho lokufakelwa izitho lizokunikeza imiyalelo ethile mayelana nokuthi ungashayela nini nokuthi ungathintwa kanjani uma kunesimo esiphuthumayo. Unganqikazi ukufinyelela uma ukhathazekile nganoma yini ngesikhathi sokululama kwakho.

Shayela udokotela wakho ngokushesha uma uhlangabezana nalokhu:

• Umkhuhlane ongaphezu kuka-101°F (38.3°C) noma amaqhafuza
• Ubuhlungu obukhulu noma obuqhubekayo obungathuthuki ngemithi
• Ububomvu, ukuvuvukala, noma ukukhipha amanzi ezindaweni zokuhlinzwa
• Ubunzima bokuchama noma izinguquko ezinkulu ekukhipheni umchamo
• Isicanucanu nokuhlanza okuvimbela ukugcina uketshezi phansi
• Ukuphefumula kanzima noma ubuhlungu besifuba
• Ukuvuvukala emilenzeni noma ukuzuza isisindo okungazelelwe

Lezi zimpawu akudingeki ukuthi zisho ukuthi kukhona okungahambi kahle, kodwa zidinga ukuhlolwa kwezokwelapha okusheshayo. Ithimba lakho lezempilo lingathanda ukukuhlola ngokungadingekile kunokuthi liphuthelwe okuthile okubalulekile.

Ukunakekelwa okuvamile kokulandela ngemuva

Ngaphandle kokukhathazeka okuphuthumayo, uzoba nokuqokwa okulandelayo okuhleliwe ukuqapha ukululama kwakho nempilo yesikhathi eside. Lokhu kuvakasha kubalulekile ekuqinisekiseni ukuthi izinso zakho ezisele zihlala ziphilile.

Uhlelo lwakho lokulandela luzohlanganisa ukuvakasha ngesonto elingu-1, inyanga engu-1, izinyanga ezi-6, nonyaka ongu-1 ngemuva kokuhlinzwa. Ngemuva kwalokho, ukuhlolwa konyaka kuvame ukwanele kubanikeli abaningi.

Imibuzo evame ukubuzwa mayelana ne-nephrectomy yomnikeli

Q.1 Ingabe i-nephrectomy yomnikeli iphephile kumnikeli?

Yebo, i-nephrectomy yomnikeli iphephile kakhulu kubanikeli abahlolwe ngokucophelela. Ingozi yezinkinga ezingathi sína ingaphansi kuka-1%, futhi abanikeli abaningi balulama ngokuphelele phakathi kwamasonto angu-4-6.

Abanikeli abaphilayo banethemba lokuphila elifanayo njengomphakathi jikelele. Izinso zakho ezisele zizozivumelanisa nokuphatha wonke umsebenzi, futhi ungaphila impilo ejwayelekile ngokuphelele ngaphandle kwemingcele.

Q.2 Ingabe ukuba nezinso elilodwa kubangela izinkinga zempilo yesikhathi eside?

Ukuba nezinso elilodwa ngokuvamile akubangeli izinkinga ezinkulu zempilo yesikhathi eside kubanikeli abaningi. Izinso zakho ezisele zingenza yonke imisebenzi edingekayo, futhi abanikeli abaningi bagcina ukusebenza kwezinso okujwayelekile phakathi nempilo yabo yonke.

Kungase kube nengozi encane yokwanda kwegazi eliphezulu noma amatshe ezinso ngokuhamba kwesikhathi, kodwa lezi zingozi zincane futhi zilawuleka ngokunakekelwa kwezempilo okuvamile.

Q.3 Kuthatha isikhathi esingakanani ukululama ngemuva kwe-nephrectomy yomnikeli?

Abanikeli abaningi babuyela emisebenzini ejwayelekile phakathi kwamasonto angu-4-6 ngemuva kwe-laparoscopic donor nephrectomy. Ngokuvamile uzohlala esibhedlela izinsuku ezingu-1-2 futhi ungabuyela emsebenzini wedeskini phakathi kwamasonto angu-2-3.

Ukuphakamisa okunzima nemisebenzi eqinile kufanele kugwenywe cishe amasonto angu-6 ukuze kuvunyelwe ukuphulukiswa okufanele. Amazinga akho wamandla azobuyela kancane kancane kokujwayelekile njengoba umzimba wakho uzivumelanisa nokuba nezinso elilodwa.

Q.4 Ngingakwazi yini ukuzivocavoca nokudlala imidlalo ngemuva kokunikela ngezinso?

Yebo, ungabuyela kuwo wonke umsebenzi ojwayelekile wokuzivocavoca nemidlalo ngemuva kokuthi ukululama kwakho kuqediwe. Ukuba nezinso eyodwa akukhawuleli amakhono akho omzimba noma ukusebenza kwezemidlalo.

Kufanele ugweme imidlalo yokuxhumana enobungozi obukhulu bokulimala ezinso zakho ezisele, kodwa lokhu kungokuzivikela okwengeziwe kunemfuneko eqinile. Ukubhukuda, ukugijima, ukuhamba ngebhayisikili, neminye imisebenzi eminingi iphephile ngokuphelele.

Q.5 Ngizodinga ukunakekelwa okukhethekile kwezokwelapha impilo yami yonke?

Uzodinga ukuhlolwa njalo ukuqapha ukusebenza kwezinso zakho, kodwa ngeke udinge imithi ekhethekile noma ukwelashwa. Ukuvakashelwa minyaka yonke nokuhlolwa kwegazi kuvame ukwanele ngemuva konyaka wokuqala.

Udokotela wakho oqeqeshwe kahle angakwazi ukusingatha iningi lokunakekelwa kwakho okulandelayo, ngokuvakashelwa ngezikhathi ezithile esikhungweni sokufakelwa. Uzoziphilela njenganoma ubani omunye, ngesisodwa nje sezinso esikhundleni sezimbili.