Dasawa da gabobin da kyallen takarda. Organ dasawa a Rasha

Gabar karancin matsala ga dasawa ne na gaggawa ga dukkan bil'adama a matsayin dukan. Game da mutane 18 suke mutuwa kowacce rana saboda rashin bayarwa gabobin da kuma taushi tsokoki, da kuma ba jiran su bi da bi. Organ dasawa a cikin zamani duniya domin mafi yawan bangare sanya daga matattu mutane, wanda lokacin da yake rayuwa hannu da dacewa takardu na yarda to kyauta bayan mutuwa.

Mene ne dasawa

Organ dasawa ne kau da gabobin ko taushi tsokoki na bayarwa da kuma canja wurin su zuwa ga mai karɓa. Babban shugabanci na dasawa ne dasawa da muhimmanci gabobin - wato, waɗanda hukumomi, tare da abin da kasancewar shi ne ba zai yiwu ba. Wadannan gabobi sun hada da zuciya, kodoji, kuma huhu. Duk da yake sauran gabobin kamar pancreas, za a iya maye gurbin maye far. Kamar yadda na yau, mai girma tsammanin ga wani tsawo na rayuwar mutum ba Gabar dasawa. Dasawa da aka samu nasarar aikata. Wannan canji na zuciya, koda, hanta, thyroid gland shine yake, cornea, saifa, huhu, da jini, da fata, guringuntsi da kashi don ƙirƙirar wani tsarin da view ga sabon nama kafa a nan gaba. A karo na farko a koda dashi don kawar da m na koda gazawar haƙuri aka za'ayi a shekara ta 1954, masu bada taimako da m tagwaye. Organ dasawa a Rasha aka farko da za'ayi da Academician Petrovskim B. V. a shekarar 1965.

Mene ne daban-daban na dasawa

A duniya akwai da yawa terminally rashin lafiya mutane a bukatar dashi ciki gabobin da kuma taushi tsokoki kazalika da gargajiya da hanyoyin da magani daga hanta, koda, huhu, zuciya, ba kawai wucin gadi taimako, amma ba su canja fundamentally haƙuri da yanayin. Organ dasawa akwai hudu iri. Na farkon su - allotransplantation - daukan wuri a cikin al'amarin, a lõkacin da mai bayarwa da karɓa ya kasance a cikin wannan jinsin, da kuma na biyu da irin ne xenotransplantation - biyu batutuwa ciki jinsuna daban. A cikin akwati inda dasawa da kyallen takarda ko gabobin samar daga m tagwaye ko dabbobi tashe a sakamakon consanguineous ma'abota, aiki ne ake kira izotransplantatsiey. A cikin farko biyu lokuta, da mai karɓa iya samun nama kin amincewa, wanda aka sa ta na rigakafi da kariya da kwayoyin zuwa kasashen waje Kwayoyin. Kuma a related nama samfurori yawanci ci kyau. A karo na hudu irin hada autotransplantation - transplanting tsokoki da kuma gabobin a cikin jiki.

shaidar

Kamar yadda yi nuna, nasarar da ake gudanar ne sun fi mayar saboda dace ganewar asali da kuma cikakken tabbatar da dalilin da gaban contraindications, kazalika da gabobin dashi aka za'ayi a dace hanya. Dasawa ya kamata a annabta da yanayin haƙuri kafin aiki da kuma bayan. Babban nuni ga tiyata ne gaban m lahani, cututtuka da kuma pathologies cewa ba za a iya bi da warkewa da kuma m hanyoyin, kazalika da barazanar haƙuri da rai. Lokacin dasawa a yara mafi muhimmanci al'amari ne domin sanin da mafi kyau duka lokacin tiyata. A cewar masana na ma'aikata kamar yadda Cibiyar dasawa, Jinkirtãwa tiyata kamata ba za a yi a kan unreasonably dogon lokaci, a matsayin bata lokaci a cikin ci gaban da matasa jiki iya zama babu ja. Dasawa da aka nuna a cikin hali na m rai hangen nesa bayan aiki dangane da siffar da Pathology.

Dasawa da gabobin da kyallen takarda

A dasawa, mafi tartsatsi autotransplantation, saboda shi gusar incompatibility da kuma nama kin amincewa. A mafi ayyukan gudanar a ranar fata dasawa, da adipose nama da tsoka, guringuntsi, kashi, niƙaƙƙun gaɓãɓuwa, jijiyoyi, pericardium. Tartsatsi jijiyoyinmu da jijiyoyin bugun gini dashi. Wannan ya yiwu godiya ga ci gaban zamani microsurgery da kuma kayan aiki ga wadannan dalilai. Babban rabo mai girma na dasawa ne dasawa da yatsun zuwa ƙafa a kan goga. By autologous dasawa ma ya hada da transfussion nasa jini tare da manyan jini asara a lokacin tiyata. Lokacin da allograft sau da yawa transplanted bargo, jini, kashi nama. Wannan rukuni na jini damuwa daga dangi. Abu mai muhimmanci da wuya a yi dasawa tiyata na kwakwalwa, muddin wannan aiki yana fuskantar babban matsaloli, amma da canja wurin da mutum segments dabba nasarar aikata. pancreas dashi ba ka damar dakatar da ci gaban irin wannan rashin lafiya mai tsanani kamar ciwon sukari. A cikin 'yan shekaru, 7-8 a 10 daga cikin ayyukan masu rabo. A daidai wannan lokaci ba gaba daya transplanted dukan jiki, amma kawai wani ɓangare - islet Kwayoyin cewa samar da insulin.

Dokar kan sashin jiki dasawa a Rasha Federation

A kan ƙasa na kasar mu da dashi masana'antu ne kayyade ta Shari'ar Rasha Federation daga 22.12.92 "A dasawa da gabobin da kuma (ko) adam nama". A Rasha, mafi sau da yawa da za'ayi koda transplants, wani lokacin da zuciya, hanta. na sashin jiki dashi dokar ya wadãtu da wannan al'amari a matsayin wata hanya ajiye rayuwa da kuma kiwon lafiya na 'yan kasa. Duk da haka, wannan dokar wani fifiko ganin adana daga cikin rãyuwar bayarwa wajen mai karɓa ta kiwon lafiya. Bisa ga dokar tarayya a kan dasawa da Gabobi, abubuwa iya zama bargo, zuciya, huhu, koda, hanta da kuma sauran kayan ciki da kyallen takarda. Kau da gabobin za a iya aiwatar kamar rai mutum, kuma da matacce. Organ dasawa ne da za'ayi kawai da aka rubuta yarda da mai karɓa. Masu bada taimako na iya zama m mutane suka yi halartar likita jarrabawa. Organ dasawa a Rasha an gudanar kyauta, kamar yadda sayar da gabobin da aka haramta doka ta.

Masu bada taimako a dasawa

A cewar Cibiyar dasawa, kowane mutum na iya zama wani mai bayarwa ga sashin jiki transplants. Domin mutane a karkashin shekara goma sha takwas da haihuwa, kana bukatar parental yarda da aiki. Lokacin da shiga cikin yarda to Gabar kyauta bayan mutuwa ganewar asali da kuma kiwon lafiya jarrabawa, wanda ba ka damar sanin abin da gabobin za a iya transplanted. Banda daga cikin jerin gudunmawa ga sashin jiki transplants da kuma nama dako na HIV, da ciwon sukari, da ciwon daji, koda cuta, zuciya da kuma sauran m pathologies. A related dasawa da aka gudanar yawanci for guda biyu gabobin - koda, huhu, da kuma unpaired gabobin - hanta, hanji, pancreas.

Contraindications don dasawa

Organ dasawa yana da wasu contraindications saboda gaban cututtuka da za a iya dada tabarbare a sakamakon da aiki da kuma barazana da haƙuri ta rayuwa, ciki har da m. All contraindications ya kasu kashi biyu kungiyoyin: cikakkar da kuma zumunta. By cikakkar sun hada da:

• cututtuka a sauran gabobin kan daidai da waɗanda ke yin mãkircin maye gurbin, ciki har da gaban da tarin fuka, cutar AIDS.
• rushewa daga aiki na muhimmanci gabobin, tsakiya m tsarin lalacewa.
• cancers.
• gaban malformations da haihuwa lahani, ba su jituwa da rai.

Duk da haka, a lokacin da shirye-shiryen ga tiyata saboda magani da kuma kawar da yawa cututtuka na cikakkar contraindications wuce a cikin category na zumunta.

koda dashi

Na musamman muhimmancin a magani daukan wani koda dashi. Tun da yake wannan ne guda biyu gaba, aka cire daga bayarwa ba ya lura cuta na jiki, barazana ransa. Saboda da peculiarities na jinin samar da transplanted koda tsira da kyau a masu karɓa. Da farko gwaje-gwajen a koda transplants da aka yi a dabbobi a 1902, wani bincike da masanin kimiyyar E. Ullman. Lokacin dashi mai karɓa, ko da a cikin rashi na taimaka jiyya su hana kin amincewa da kasashen waje zuciya da sauransu zauna kadan fiye da watanni shida. Da farko, da transplanted koda a cinya, amma daga baya tare da ci gaban da tiyata da aka gudanar dasawa tiyata a ta pelvic yankin, wannan hanya da aka aikata a wannan rana. A farko koda dashi da aka yi a shekara ta 1954 tsakanin m tagwaye. Sai aka gudanar a 1959. Sannan The gwaji na wata koda dashi fraternal tagwaye, kuma da dabara amfani da} alubalantar dasa kin amincewa, kuma shi ya tabbatar da tasiri a yi. sababbin kayayyakin aiki, abin da zai iya toshe jiki ta halitta sunadaran, ciki har da azathioprine aka gano, wanda cike da jiki ta rigakafi defenses da aka gano. Daga yanzu a dasawa sun zama yadu amfani immunosuppressants.

kiyayewa gawarwakin

Duk wani m sashin jiki, wanda aka yi nufi ga dasawa ba tare da jinin samar da oxygen ne batun komowar canje-canje, bayan da an dauke m for dasawa. Domin duk gabobin, wannan lokaci da aka lasafta a cikin hanyoyi daban-daban - ga zuciya, lokacin da aka auna a minti, domin a koda - 'yan sa'o'i. Saboda haka, babban abu na dasawa ne don adana da gabobin da kuma kula da su yi har zuwa dashi cikin wani kwayoyin. Don warware wannan matsala, yin amfani da canning, wanda shi ne samar da jiki da oxygen da kuma sanyaya. Koda haka da cewa za ka iya ajiye for 'yan kwanaki. Gabar adana zai iya ƙara lokacin da bincike da kuma zabin da masu karɓa.

Kowace daga cikin jikinsu bayan samun shi dole hõre adana, wannan da aka sanya shi a cikin wani akwati da bakararre kankara, sa'an nan gudanar da wani musamman adana bayani a zazzabi na 40 digiri Celsius. Mafi sau da yawa amfani ga wadannan dalilai bayani kira Custodiol. Perfusion yana dauke da cikakken kõma a lokacin da bakinsu na jijiya dasa protrudes m jini hana aifuwa na maza bayani ba tare da impurities. Bayan wannan jikin da aka sanya a cikin wani adana bayani, wanda aka bar zuwa lokacin da aiki.

dashi kin amincewa

Lokacin da transplanting da dashi a cikin mai karɓa kwayoyin shi ya zama abu na immunological mayar da martani. A sakamakon haka, da m mai karɓa rigakafi da tsarin dauki daukan sanya wani yawan matakai a salon salula matakin da kai ga kin amincewa da transplanted sashin jiki. Wadannan matakai suna bayyana ƙarni na bayarwa-takamaiman antibodies da antigens na mai karɓa ta rigakafi da tsarin. Akwai iri biyu na kin amincewa - humoral da hyperacute. A m siffofin ci gaba duka biyu kin amincewa da inji.

Gyaran fuska da kuma immunosuppressive magani

Don hana wannan gefe sakamako na immunosuppressive far an wajabta, dangane da irin aiki, da jini kungiyar, da mataki na karfinsu na bayarwa da kuma karba sako, da kuma haƙuri da yanayin. The karami kin amincewa lura a related dasawa da gabobin da kyallen takarda, kamar yadda a cikin wannan hali, kamar yadda mai mulkin, 3-4 antigen daga 6 daidaita. Saboda haka, da karami kashi na immunosuppressants. A mafi kyau rayuwa nuna hanta dashi. Yi ya nuna cewa jiki na nuna wani mai fiye da goma-shekara rayuwa kudi bayan tiyata a 70% da marasa lafiya. Tsawo dauki na mai karɓa kuma dasa microchimerism auku, kyale lokaci zuwa hankali rage kashi na immunosuppressants har sai da cikakken kin amincewa da su.