Ke kuʻi puʻuwai

ʻO kahi transplant puʻuwai kahi ʻoki e wehe i kahi puʻuwai i hōʻino ʻia a maʻi paha a hoʻololi iā ia me kahi puʻuwai hāʻawi ola olakino.

Ke paʻakikī nei ka loaʻa ʻana o kahi naʻau hāʻawi. Pono e hāʻawi ʻia ka puʻuwai e kekahi mea make i ka lolo akā ke kākoʻo nei i ke ola. Pono ka naʻau hāʻawi i kahi kūlana maʻamau me ka ʻole o ka maʻi a pono e hoʻohālikelike ʻia me kou koko a me / a i ʻole ʻano kikoʻī e hōʻemi ai i ka manawa e hōʻole ai kou kino iā ia.

Hoʻokomo ʻia ʻoe i kahi hiamoe nui me ka anesthesia ākea, a ʻoki ʻia i loko o ka umauma.

• Ke kahe nei kou koko i loko o ka mīkini holoʻokoʻa puʻuwai puʻuwai ʻoiai ke kaukō lapaʻau e hana ana i kou puʻuwai. Hana kēia mīkini i ka hana o kou puʻuwai a me kou mau māmā ʻoiai lākou e paʻa ana, a hāʻawi i kou kino i ke koko a me ka oxygen.
• Lawe ʻia kou puʻuwai maʻi a humuhumu ʻia ka naʻau hāʻawi. Hoʻokaʻawale ʻia ka mīkini puʻuwai puʻuwai. Kahe ke koko i loko o ka puʻuwai transplanted, ka mea e lawe i ka hāʻawi ʻana i kou kino i ke koko a me ka oxygen.
• Hoʻokomo ʻia nā paipu e hoʻokahe i ka ea, ka wai, a me ke koko mai ka umauma no kekahi mau lā, a e ʻae hou i nā akemāmā.

Hana ʻia kahi transplant puʻuwai e mālama:

• Poino nui ka naʻau ma hope o ka puʻuwai puʻuwai
• ʻO ke kīnā ʻole o ka puʻuwai nui, ke kōkua hou ʻole nā ​​lāʻau, nā lapaʻau ʻē aʻe, a me ke kaha ʻana
• ʻO nā kīnā o ka puʻuwai nui i kū ma ka wā hānau a ʻaʻole hiki ke hoʻopaʻa ʻia me ke ʻoki
• ʻO nā puʻuwai abnormalities e hoʻoweliweli nei i ke ola e pane ʻole i nā lāʻau ʻē aʻe

ʻAʻole hiki ke hoʻohana ʻia ke kahakaha transplant puʻuwai i ka poʻe nāna:

• ʻAno ʻai maikaʻi ʻole
• ʻOi aku ka makahiki ma mua o 65 a 70 paha
• Ua loaʻa i kahi ʻeha koʻikoʻi a dementia paha
• Loaʻa i ka maʻi ʻaʻai ma mua o 2 mau makahiki i hala
• Loaʻa i ka maʻi HIV
• Loaʻa nā maʻi, e like me ka hepatitis, e hana nei
• Loaʻa i ka mimikō hilinaʻi i ka insulin a me nā mea ʻē aʻe, e like me nā puʻupaʻa, ʻaʻole holo pono
• Loaʻa nā puʻupaʻa, ʻūhā, nā aʻalolo, a i ʻole nā ​​maʻi ate
• ʻAʻohe kākoʻo ʻohana a mai ukali i kā lākou lapaʻau ʻana
• Loaʻa i nā maʻi ʻē aʻe e pili i nā kīʻaha koko o ka ʻāʻī a me ka wāwae
• Loaʻa i ka pulmonary hypertension (ka mānoanoa o nā kīʻaha koko i ka māmā)
• Puhi a hōʻino paha i ka waiʻona a lāʻau paha, a i ʻole nā ​​ʻano nohona ʻē aʻe e hoʻopōʻino i ka puʻuwai hou
• ʻAʻole lawa ka hilinaʻi e lawe i kā lākou lāʻau, a i ʻole hiki i ke kanaka ke hoʻomau me ka nui o nā kipa a me nā hoʻokipa a nā keʻena olakino.

Nā pilikia o kekahi anesthesia:

• Nā hopena i nā lāʻau
• Pilikia i ka hanu ʻana

ʻO nā pōʻino mai nā ʻoki kino:

• Kahena
• Maʻi kīnā

ʻO nā pōʻino o ke transplant nā:

• Koko koko (deep venous thrombosis)
• Poino i nā puʻupaʻa, ke ake, a i ʻole nā ​​mea ʻē aʻe mai nā lāʻau anti-rejection
• Hoʻomohala ʻia ka maʻi ʻaʻai mai nā lāʻau i hoʻohana ʻia e pale i ka hōʻole ʻana
• Ka hōʻeha puʻuwai a i ʻole hōʻeha
• Nā pilikia puʻuwai puʻuwai
• Nā pae kolesterol kiʻekiʻe, ka maʻi diabetes, a me ka iwi lahilahi mai ka hoʻohana ʻana o nā lāʻau hōʻole
• Hoʻonui i ka makaʻu no nā maʻi ma muli o nā lāʻau anti-rejection
• Hewa ka puʻuwai a me ka hakuʻala
• Ka hōʻole ʻana o ka puʻuwai
• Maʻi maʻi ʻaʻa nui
• Nā maʻi hōʻeha
• ʻAʻole holo iki paha ka naʻau hou

Ke kuhikuhi ʻia ʻoe i kahi kikowaena transplant, e loiloi ʻia ʻoe e ka hui transplant. Makemake lākou e hōʻoia he moho maikaʻi ʻoe no kahi transplant. E kipa pinepine ʻoe i mau pule a i ʻole mau mahina. Pono ʻoe e kiʻi i ke koko a lawe ʻia nā kukuna. Hana ʻia kēia aʻe:

• Nā hōʻoia koko a ʻili paha e nānā ai i nā maʻi
• Nā hoʻāʻo o kou puʻupaʻa a me ke ake
• Nā ho'āʻo e loiloi i kou puʻuwai, e like me ECG, echocardiogram, a me ka catheterization puʻuwai
• Nā hoʻāʻo e nānā i ka maʻi ʻaʻai
• ʻO ka kele a me ke kikokiko ʻana i ke koko, e kōkua e hōʻoia i ka hōʻole ʻole o kou kino i ka puʻuwai i hāʻawi ʻia
• Ultrasound o kou ʻāʻī a me kou mau wāwae

Makemake ʻoe e nānā i hoʻokahi a ʻoi paha o nā kikowaena transplant e ʻike ʻoi aku ka maikaʻi no ʻoe:

• E nīnau iā lākou i ka nui o nā transplants a lākou e hana ai i kēlā me kēia makahiki a he aha nā helu e ola ai. Hoʻohālikelike i kēia helu me nā helu mai nā kikowaena ʻē aʻe. Loaʻa kēia mau mea āpau ma ka pūnaewele ma unos.org.
• E nīnau he aha nā hui kākoʻo i loaʻa a me ka nui o nā kōkua a lākou e hāʻawi ai me ka huakaʻi a me nā hale.
• E nīnau e pili ana i nā kumukūʻai o nā lāʻau e pono ai e lawe ma hope a inā he kōkua kālā i ka loaʻa ʻana o nā lāʻau.

Inā manaʻo ka kipa transplant he moho maikaʻi ʻoe, e kau ʻia ʻoe ma kahi papa inoa kali ʻāina no ka puʻuwai.

• Hoʻokumu ʻia kāu wahi ma ka papa inoa ma nā kumu he nui. ʻO nā kumu nui pū kekahi me ke ʻano a me ke koʻikoʻi o kou maʻi puʻuwai, a pehea kou maʻi i ka manawa āu e helu ai.
• ʻO ka nui o ka manawa āu e hoʻolilo ai i kahi papa inoa kali ʻana ʻaʻole ia he mea no ka manawa koke e loaʻa ai ka puʻuwai, koe wale nō ma nā hihia o nā keiki.

ʻO ka hapa nui, akā ʻaʻole ka poʻe āpau, ke kali nei nā poʻe no ke kuʻi puʻuwai he maʻi nui loa lākou a pono i ka haukapila. Pono nā mea he nui i kekahi ʻano hana e kōkua i ko lākou puʻuwai e pauma i ke koko i ke kino. ʻO ka pinepine, he kōkua kōkua ventricular kēia (VAD).

Pono ʻoe e noho i ka haukapila no 7 a 21 mau lā ma hope o ke kuʻi puʻuwai. ʻO ka 24 mua a 48 mau hola paha i loko o ka keʻena mālama nui (ICU). I nā lā mua ma hope o ke kuʻi ʻana, pono ʻoe i ka ukali pili e ʻike pono ʻaʻole ʻoe e loaʻa i kahi maʻi a ke holo pono nei kou puʻuwai.

ʻO ka manawa hoʻōla e pili ana i 3 mau mahina a pinepine, e noi ana kāu hui transplant iā ʻoe e noho kokoke i ka haukapila i kēlā manawa. Pono ʻoe e nānā maʻamau me nā hoʻokolohua koko, x-ray, a me nā echocardiograms no nā makahiki he nui.

ʻO ka hakakā ʻana i ka hōʻole he hana hoʻomau ia. Manaʻo ka ʻōnaehana pale o ke kino i ka mea i hoʻoulu ʻia he kino haole a hakakā me ia. No kēia kumu, pono nā mea maʻi transplant i nā lāʻau e hōʻemi i ka pane pale o ke kino. I mea e pale aku ai i ka hōʻole, he mea nui ia e lawe i kēia mau lāʻau a mālama pono i kāu ʻōlelo mālama iā ʻoe iho.

Hana pinepine ʻia nā biopsies o ka puʻuwai puʻuwai i kēlā me kēia mahina ma ka mua o 6 a 12 mau mahina ma hope o ke kanu ʻana, a laila emi pinepine ma hope o kēlā. Kōkua kēia i ka hoʻoholo inā hōʻole kou kino i ka puʻuwai hou, ʻoiai ma mua o kou loaʻa ʻana o nā ʻōuli.

Pono ʻoe e lawe i nā lāʻau i pale i ka hōʻole transplant no ke koena o kou ola. Pono ʻoe e hoʻomaopopo pehea e lawe ai i kēia mau lāʻau, a ʻike i kā lākou hopena.

Hiki iā ʻoe ke hoʻi i kāu mau hana maʻamau 3 mau mahina ma hope o ke transplant ke loaʻa kahi maikaʻi iā ʻoe, a ma hope o ke kamaʻilio ʻana me kāu kauka olakino. E kūkākūkā i kāu mea hāʻawi inā ʻoe e hoʻolālā e komo i ka hoʻoikaika kino ikaika.

Inā hoʻomohala ʻoe i ka maʻi coronary ma hope o kahi transplant, loaʻa paha iā ʻoe kahi catheterization cardiac i kēlā me kēia makahiki.

Hoʻolōʻihi ke ola ʻana o ka naʻau i ke ola o ka poʻe make make ʻole. Ma kahi o 80% o nā mea maʻi hoʻoliʻiliʻi naʻau e ola nei 2 mau makahiki ma hope o ka hana. Ma 5 mau makahiki, 70% o nā mea maʻi e ola mau ana ma hope o ke kuʻi puʻuwai.

ʻO ka pilikia nui, e like me nā transplants ʻē aʻe, ka hōʻole. Inā hiki ke kāohi ʻia ka hōʻole ʻana, hoʻonui ʻia ke ola ma mua o 10 mau makahiki.

Ke kuʻi aku i ka naʻau; Transplant - puʻuwai; Transplantation - puʻuwai

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• Anatomy maʻamau o ka puʻuwai
• ʻO ke kuʻi naʻau - series

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ʻO Jessup M, Atluri P, ʻAcker MA. Hoʻoponopono ʻoki lāʻau ʻana o ka puʻuwai. I: Zipes DP, Libby P, Bonow RO, Mann, DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 28.

ʻO Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Pediatric puʻuwai a me ka puʻuwai-transplantation. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 470.

ʻO Mancini D, Naka Y. Ke kanu ʻana i ka naʻau. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 82.

ʻO Yancy CW, Jessup M, Bozkurt B, et al. ʻO 2017 ACC / AHA / HFSA Hoʻolaha Hoʻolaha o ka 2013 ACCF / AHA alakaʻi no ka mālama ʻana i ka puʻuwai puʻuwai: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force e pili ana i nā kuhikuhi Clinical Practice and the Heart Failure Society of America. J Kāleka Kāleka. 2017; 23 (8): 628-651. PMID: 28461259 www.ncbi.nlm.nih.gov/pubmed/28461259.