ʻO ka hōʻole transplant

ʻO ka hōʻole transplant kahi hana e hoʻouka ai ka ʻōnaehana pale o ka mea loaʻa transplant i ka mea i hoʻoulu ʻia a i ʻole kaʻiʻo.

Pale mau ka pale pale o kou kino iā ʻoe mai nā mea ʻino e hoʻopōʻino paha, e like me nā mikena, nā mea ʻawahia, a i kekahi manawa, nā hunaola maʻi ʻaʻai.

ʻO kēia mau mea ʻino nā protein i kapa ʻia he antigens e uhi ana i ko lākou mau ʻilikai. Ke komo koke kēia mau antigens i loko o ke kino, ʻike ka ʻōnaehana pale pilikino ʻaʻole lākou mai ke kino o kēlā kanaka a "haole" lākou, a hoʻouka iā lākou.

Ke loaʻa i ke kanaka kahi lālā mai kekahi mea ʻē aʻe i ka wā o ke kāpili transplan, ʻike ke ʻōnaehana pale ʻino o kēlā kanaka he haole ia. ʻO kēia no ka mea ʻike ka ʻōnaehana pale o ke kanaka i ka ʻokoʻa o nā antigens ma nā hunaola o ka meaola a ʻaʻole "kūlike." Hiki i nā ʻōpala i kūlike ʻole ʻia, a i ʻole nā ​​ʻoka i kūlike ʻole ʻole, hiki ke hoʻoulu i ka hopena o ke transfusion koko a i ʻole ka rejection rejection.

I mea e pale aku ai i kēia hopena, kikokiko ʻia nā kauka, a i ʻole hoʻohālikelike ʻia i ka mea hāʻawi organ a me ke kanaka e loaʻa ana ka ʻokena. ʻO ka like like o nā antigens ma waena o ka mea hāʻawi a me ka mea e loaʻa ana, ka liʻiliʻi o ka hōʻole ʻia ʻana o ke ʻano.

Hoʻomaopopo ka kikokiko kikokiko ʻana i ke ʻano a me nā ʻano like ʻole e like me ka mea hiki i nā nāʻa o ka mea e loaʻa ana. ʻAʻole kūpono ka match. ʻAʻohe kanaka ʻelua, koe wale nō nā māhoe like, i loaʻa i nā antigens kikoʻī like.

Hoʻohana nā kauka i nā lāʻau e kāohi i ka ʻōnaehana pale o ka mea e loaʻa ana. ʻO ka pahuhopu ka mea e pale aku ai i ka ʻōnaehana pale maʻi mai ka hoʻouka ʻana i ka ʻōnaehana hou i kanu hou ʻia ke kūlike ʻole ʻole ka ʻokana Inā hoʻohana ʻole ʻia kēia mau lāʻau, kokoke i ke kino e hoʻomaka i kahi pane pale a luku i ka mea haole.

Aia kekahi mau hoʻokoe. ʻAʻole hōʻole ʻia nā mea koliʻe no ka mea ʻaʻohe lako o ke koko. Eia kekahi, ʻo nā transplants mai kekahi māhoe like i kahi ʻē aʻe aneane loa e hōʻole ʻia.

ʻEkolu ʻano o ka hōʻole ʻana:

• Hana ʻia ka hōʻole ʻo Hyperacute i kekahi mau minuke ma hope o ke transplant ke kūlike ʻole nā ​​antigens. Pono e hemo koke ke kiko i laila ʻaʻole make ka mea loaʻa. ʻIke ʻia kēia ʻano hōʻole ke hāʻawi ʻia i kahi mea loaʻa i ke ʻano hewa o ke koko. ʻO kahi laʻana, ke hāʻawi ʻia i kahi kanaka ke ʻano ʻAno ke ʻano B ʻo ia.
• Hiki ke hōʻole koʻikoʻi i kēlā me kēia manawa mai ka pule mua ma hope o ke kuʻi ʻana i 3 mau mahina ma hope. Loaʻa i nā mea loaʻa i kahi nui o ka hōʻole nui.
• Hiki ke hōʻole ʻia i nā wā he nui i nā makahiki he nui. ʻO ka pane mau ʻana o ke kino e kūʻē i ka mea hou e hōʻino mālie i nā mea i hoʻoiho ʻia a i ʻole nā ​​meaola.

Pākuʻi ʻia paha nā ʻōuli:

• E hoʻomaka paha ka emi ʻana o ka hana a ke koʻokoʻo
• General discomfort, uneasiness, a i ʻole maʻi manaʻo
• ʻEha a pehu paha i ka wahi o ka organ (laha ʻole)
• Fever (pohihihi)
• ʻO nā ʻōuli e like me ka flu, e like me ka haʻalulu, ka ʻeha o ke kino, kahoʻi, kahe, a me ka hanu liʻiliʻi

Pili nā ʻōuli i ka mea i hoʻoulu ʻia a i ʻole nā ​​mea i hoʻoulu ʻia. ʻO kahi laʻana, ʻo nā mea maʻi e hōʻole i kahi puʻupaʻa e loaʻa ka liʻiliʻi o ka mimi, a ʻo nā mea maʻi e hōʻole i ka puʻuwai e loaʻa paha nā ʻōuli o ka puʻuwai ʻole.

E nānā ke kauka i kahi ma a ma kahi o ka mea kanu i loli.

ʻO nā hōʻailona ʻaʻole e hana pono ka ʻāpana i:

• ʻO ke kō koko kiʻekiʻe (pancreas transplant)
• Ua hoʻokuʻu ʻia ka mimi liʻiliʻi (transplant kidney)
• Ka hanu ʻana o ka hanu a me ka liʻiliʻi o ka hiki ke hoʻoikaika kino (hoʻoneʻe ka puʻuwai a i ʻole transplant lung)
• Waihoʻoluʻu melemele a maʻalahi ke kahe ʻana o ke ake (ka hoʻoliʻiliʻi ate)

Hiki i kahi biopsy o ke organ transplanted ke hōʻoia he hōʻole ʻia ia. Hana ʻia kahi biopsy maʻamau i kēlā me kēia manawa e ʻike i ka hōʻole i ka wanaʻao, ma mua o ka ulu ʻana o nā ʻōuli.

Ke kānalua ʻia ka hōʻole ʻana o nā ʻola, e hana ʻia hoʻokahi a ʻoi paha o nā hoʻokolohua aʻe ma mua o ka biopsy o ka meaola.

• Scanner CT ʻōpū
• Pākuʻi x-ray
• ʻO ka echocardiography naʻau
• ʻOihana arenalography
• Pākuʻi ultrasound
• Nā hoʻokolohua lab o ka hakuʻala a i ʻole ka hana ate

ʻO ka pahuhopu o ka mālama ʻana e hōʻoia i ka hana o ke kolo a i ʻole nā ​​mea i hana pono ʻia, a e kāohi i ka pane o kāu ʻōnaehana pale. Ke kāohi nei i ka pane pale pale e pale ai i ka hōʻole transplant.

E hoʻohana ʻia nā lāʻau e kāohi ai i ka pane pale. ʻO ka hana a me ke koho ʻana o nā lāʻau i pili i kou ʻano. Kiʻekiʻena paha ke ana ma mua o ka hōʻole ʻia ʻana o ke ʻano. Ma hope o kou ʻole he hōʻailona o ka hōʻole, e hoʻohaʻahaʻa ʻia ke ana.

ʻOi aku ka holomua o kekahi mea hoʻoliʻiliʻi organ a me nāʻaʻa ma mua o nā poʻe ʻē aʻe. Inā hoʻomaka ka hōʻole ʻana, nā lāʻau e kāohi i ka ʻōnaehana paleʻea e hoʻopau i ka hōʻole. Pono ka hapa nui o ka poʻe e lawe i kēia mau lāʻau no ke koena o ko lākou ola.

ʻOiai hoʻohana ʻia nā lāʻau e kāohi i ka ʻōnaehana pale, hiki nō i nā transplants organ ke holo pono ma muli o ka hōʻole ʻia.

ʻAʻole hiki i nā ʻāpana hoʻokahi o ka hōʻole loa ke alakaʻi i ka maikaʻi ʻole o nā meaola.

ʻO ka hōʻole ʻana ke kumu ke kumu o ka holo pono ʻole ʻana o nā meaola. Lilo mālie ke koʻokoʻo i kāna hana a hoʻomaka nā ʻōuli e hōʻike. ʻAʻole hiki ke mālama pono ʻia kēia ʻano hōʻole me nā lāʻau. Pono paha kekahi poʻe i kahi transplant.

ʻO nā pilikia olakino i hopena ʻia mai ke transplant a i ʻole ka hōʻole transplant e komo pū me:

• Kekahi mau maʻi ʻino (i kekahi poʻe e lawe i nā lāʻau kūpale-pale ikaika no ka manawa lōʻihi)
• Nā maʻi ʻino (no ka mea ua kāohi ʻia ka ʻōnaehana pale maʻi o ke kanaka e ka lawe ʻana i nā lāʻau pale-ʻino)
• Ka nalowale o ka hana i loko o ka mea kanu / mea kanu i kanu ʻia
• Nā hopena o nā lāʻau, a he ʻeha paha

Kāhea i kāu kauka inā ʻaʻole i hana maikaʻi ke kolo a i ʻole nā ​​mea i hoʻoulu ʻia, a i ʻole inā ʻike ʻia nā ʻōuli ʻē aʻe. E kāhea aku i kāu kauka inā loaʻa nā hopena ʻē aʻe mai nā lāʻau āu e lawe nei.

ʻO ke kikokiko ʻana o ABO a me ka HLA (kikokiko antigen) ke kikokiko ʻana ma mua o ke transplant kōkua e hōʻoia i ka pili pono.

E pono paha ʻoe e ʻai i ka lāʻau e kāohi i kou ʻōnaehana paleʻea no ke koena o kou ola e pale aku ai i ka hōʻole ʻia o nā kikoʻī.

Ke akahele e pili ana i ka lawe ʻana i kāu lāʻau lapaʻau hope-transplant a ke nānā pono ʻia e kāu kauka e kōkua paha i ka pale ʻana i ka hōʻole.

Hōʻole Graft; Hoʻowahāwahā kaʻaʻaʻa / ʻokena

• Nā Antibodies

Abbas AK, Lichtman AH, Pillai S. Transplantation immunology. I: Abbas AK, Lichtman AH, Pillai S, eds. Pūnaewele Immunology. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 17.

Adams AB, Ford M, Larsen CP. ʻO ka immunobiology transplantation a me ka immunosuppression. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery: Ke kumu kumu olaola o ka hana ʻoki ʻana o kēia ao. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 24.

ʻO Tse G, Marson L. Immunology o ka hōʻole graft. I: Forsythe JLR, hoʻoponopono. Transplantation: kahi hoa pili i ka hana ʻoki kino hoʻomalu. 5th lā. Piladelapia, PA: Elsevier Saunders; 2014: chap 3.