Ka hoʻoliʻiliʻi ate

ʻO ke kāpili o ke akepaʻa he ʻōpala e hoʻololi i kahi akepaʻa maʻi me ke ake olakino.

No ke akepaʻa i hāʻawi ʻia mai:

• ʻO kahi mea hāʻawi i make iho nei a ʻaʻole ʻeha ʻo ke ake. Kāhea ʻia kēia ʻano mea hāʻawi manawaleʻa he cadaver donor.
• I kekahi manawa, hāʻawi ke kanaka olakino i kahi ʻāpana o kona ake i kekahi kanaka me ke ake maʻi. ʻO kahi laʻana, hiki i kahi makua ke hāʻawi manawaleʻa i kāna keiki. Kapa ʻia kēia ʻano mea hāʻawi he mea hāʻawi ola. Hiki i ke ake ke hoʻoulu hou iā ia iho. Pau nā kānaka ʻelua i nā ʻāpana hana piha ma hope o kahi transplant kūleʻa.

Lawe ʻia ke akepaʻa hāʻawi i loko o kahi wai paʻakai i hoʻoluʻu ʻia (saline) e mālama ai i ke kinikini a hiki i 8 mau hola. Hiki ke hana i nā hoʻokolohua kūpono e kūlike me ka mea hāʻawi a me ka mea loaʻa.

Lawe ʻia ke ake hou mai ka mea hāʻawi kālā ma o kahi ʻoki ʻoki ʻana i ka ʻōpū luna. Hoʻokomo ʻia ia i loko o ke kanaka e pono ai ke ake (i kapa ʻia ka mea e loaʻa ana) a hoʻopili ʻia i nā kīʻaha koko a me nā aʻa o ka bile. Lawe ʻia ka hana a 12 mau hola. Pono ka mea e loaʻa pinepine i ka nui o ke koko ma o kahi transfusion.

Hana kahi akepa olakino ma mua o 400 mau hana i kēlā me kēia lā, me:

• Ke hana nei i ka bile, kahi mea nui i ka digestion
• Ke hana nei i nā protein i kōkua i ke kāpili ʻana o ke koko
• Ke wehe a hoʻololi paha i nā bacteria, nā lāʻau, a me nā toxins i loko o ke koko
• Ka mālama ʻana i nā kō, nā momona, hao, keleawe, a me nā wikamina

ʻO ke kumu maʻamau no ka hoʻoliʻiliʻi ate i nā keiki ka biliary atresia. I ka hapanui o kēia mau hihia, ʻo ka transplant mai kahi mea hāʻawi ola.

ʻO ke kumu maʻamau no ka hoʻoliʻiliʻi ate i nā mākua ka cirrhosis. ʻO ka Cirrhosis ke ʻāʻī nei i ke ake e pale i ke akepaʻa mai ka hana maikaʻi ʻana. Hiki ke hoʻonui i ke kūleʻa o ke ake. ʻO nā kumu maʻamau o ka cirrhosis:

• ʻO ka maʻi lōʻihi loa me ka maʻi hepatitis B a i ʻole hepatitis C
• Ka hana ʻino lōʻihi
• ʻO Cirrhosis ma muli o ka maʻi akepaʻa momona ʻona ʻole
• ʻIke kūpilikiʻi mai kahi overdose o acetaminophen a i ʻole ma muli o ka ʻai ʻana i nā huaale ʻawahia.
  

ʻO nā maʻi ʻē aʻe e hiki ai ke hōʻeha i ka cirrhosis a me ke kō ʻole o ke ake.

• ʻO ka hepatitis autoimmune
• Hepatic aa koko koko clot (thrombosis)
• ʻO ka hōʻino o ke ake mai ka lāʻau make a lāʻau paha
• Nā pilikia me ka ʻōnaehana hoʻokahe o ke ake (ka biliary tract), e like me ka cirrhosis biliary mua a i ʻole cholangitis sclerosing mua
• Nā maʻi Metabolic o ke keleawe a hao paha (maʻi Wilson a me hemochromatosis)

ʻO ka ʻoki ʻana o ka hoʻoliʻiliʻi ate ʻaʻole ia e koi ʻia no ka poʻe i loaʻa.

• ʻO kekahi mau maʻi, e like me tuberculosis a i ʻole osteomyelitis
• Ka paʻakikī e lawe i nā lāʻau i mau manawa i kēlā me kēia lā no ke koena o ko lākou ola
• ʻO ka maʻi puʻuwai a i ʻole māmā (a i ʻole nā ​​maʻi hoʻoweliweli ʻē aʻe)
• Mōʻaukala o ka maʻi ʻaʻai
• Nā maʻi ʻino, e like me ka maʻi hepa, i manaʻo ʻia he ʻeleu
• ʻO ka puhipaka, ka ʻalekohola a i ʻole ka hōʻino ʻana i ka lāʻau, a i ʻole nā ​​ʻano nohona ʻino aʻe

Nā pilikia no kekahi anesthesia:

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

ʻO nā pōʻino no kēlā me kēia ʻoki kino:

• Kahena
• Ka hōʻeha puʻuwai a i ʻole hōʻeha
• Maʻi kīnā

ʻO ke kāpili transplant a me ka hoʻokele ma hope o ke kahakaha lawe i nā pilikia nui. Nui aʻe ka makaʻu no ka maʻi maʻi no ka mea pono ʻoe e lawe i nā lāʻau e kāohi i ka ʻōnaehana pale pale e pale ai i ka hōʻole transplant. ʻO nā hōʻailona o ka maʻi pū kekahi:

• Pohā
• Hoʻokahekahe
• Fiva
• ʻO Jaundice
• ʻUlaʻula
• ʻŌhū
• Malimali

E kuhikuhi aku kāu mea mālama ola iā ʻoe i kahi kikowaena transplant. E makemake ka hui transplant e koho pono ʻoe i moho no ka hoʻoliʻiliʻi ate. E kipa aku ana ʻoe i mau pule a i ʻole mau mahina. Pono ʻoe e kiʻi i ke koko a lawe ʻia nā kukuna.

Inā ʻo ʻoe ke kanaka e loaʻa ana i ke ake hou, e hana ʻia kēia mau hoʻāʻo ma mua o ke kaʻina hana.

• ʻO ka huikau a me ke kikokiko ʻana e hōʻoia i ka hōʻole ʻole o kou kino i ke akepaʻa i hāʻawi ʻia
• Nā ho'āʻo koko a i ʻole nā ​​hoʻāʻo ʻana o ka ʻili e nānā ai no ka maʻi
• Nā ho'āʻo puʻuwai e like me ECG, echocardiogram, a i ʻole catheterization puʻuwai
• Nā hoʻāʻo e nānā no ka maʻi ʻaʻai mua
• ʻO nā hoʻāʻo e nānā i kou ake, gallbladder, pancreas, ʻōpū liʻiliʻi, a me nā kīʻaha koko a puni ke ake
• ʻO Colonoscopy, kaukaʻi ʻia i kou mau makahiki

Hiki iā ʻoe ke koho e nānā i hoʻokahi a ʻoi o nā kikowaena transplant e hoʻoholo ai i nā mea kūpono loa nāu.

• E nīnau i ke kikowaena ehia mau transplants a lākou e hana ai i kēlā me kēia makahiki, a me kā lākou helu ola. Hoʻohālikelike i kēia helu i nā helu o nā kikowaena transplant.
• E nīnau he aha nā hui kākoʻo i loaʻa iā lākou, a he aha nā huakaʻi a me nā hoʻonohonoho hale a lākou e hāʻawi ai.
• E nīnau he aha ka manawa kali maʻamau no ka hoʻoliʻiliʻi ate.

Inā manaʻo ka hui transplante he moho maikaʻi ʻoe no ka hoʻoliʻiliʻi ate, e hoʻokau ʻia ʻoe i ka papa inoa kali aupuni.

• Hoʻokumu ʻia kāu wahi ma ka papa inoa kali ma nā helu he nui. ʻO nā mea nui i loko o ke ʻano o nā pilikia ate i loaʻa iā ʻoe, pehea ke koʻikoʻi o kou maʻi, a me ka likelihood e holo pono kahi transplant.
• ʻO ka manawa āu e hoʻolilo ai i kahi papa inoa kali ʻaʻole pinepine kahi kumu i ka loaʻa koke ʻana o kou ake, me ka ʻokoʻa o nā keiki.

ʻOiai ʻoe e kali ana no ke ake, e hāhai i kēia mau kaʻina hana:

• E hāhai i nā papaʻai āpau a kāu hui transplant i paipai ai.
• Mai inu rama.
• Mai puhi.
• E mālama i kou kaumaha i ka pae kūpono. E hāhai i ka papahana hoʻoikaika kino a kāu mea hāʻawi.
• E lawe i nā lāʻau āpau i kauoha ʻia nāu. Hōʻike i nā loli i kāu mau lāʻau a me nā pilikia olakino hou a ʻoi aku paha i ka hui transplant.
• E hāhai me kāu mea hoʻolako maʻamau a me ka hui transplant i nā manawa i koho ʻia.
• E ʻike pono i ka hui transplant i kāu helu kelepona pololei, i hiki iā lākou ke hoʻopili koke iā ʻoe inā loaʻa ke ake. E hōʻoia inā, ma kahi āu e hele nei, hiki ke hoʻopili koke ʻia iā ʻoe me ka maʻalahi.
• E hoʻomākaukau i nā mea āpau ma mua o ka manawa e hele i ka haukapila.

Inā loaʻa iā ʻoe kahi akepaʻa i hāʻawi ʻia, pono paha ʻoe e noho i ka haukapila no hoʻokahi pule a ʻoi paha. Ma hope o kēlā, pono e ukali pono ʻoe e ke kauka no ke koena o kou ola. E loaʻa iā ʻoe nā hoʻokolohua koko maʻamau ma hope o ke transplant.

ʻO ka wā hoʻōla e pili ana iā 6 a 12 mau mahina. E noi paha kāu hui transplant iā ʻoe e noho kokoke i ka haukapila no nā mahina 3 mua. Pono ʻoe e nānā maʻamau, me nā hoʻokolohua koko a me nā kukuna x no nā makahiki he nui.

ʻO ka poʻe i loaʻa ka hoʻoliʻiliʻi ate e hōʻole paha i ka mea hou. ʻO kēia ke ʻike nei kā lākou ʻōnaehana paleʻaleʻa i ke ake hou me he mea lā haole a hoʻāʻo e luku iā ia.

I mea e hōʻole ʻia ai, ʻaneʻane pono nā mea lawe transplant a pau i nā lāʻau e kaomi i kā lākou pane pale pale no ko lākou koena o ko lākou ola. Kāhea ʻia kēia ʻo ka lāʻau hoʻomalu immunosuppressive. ʻOiai kōkua ka lāʻau lapaʻau i ka pale ʻana i nā ʻōpala, hāʻawi ia i ka poʻe i kahi kiʻekiʻe kiʻekiʻe no ka maʻi a me ka maʻi ʻaʻai.

Inā ʻoe e ʻai i ka lāʻau immunosuppressive, pono ʻoe e nānā maʻamau no ka maʻi ʻaʻai. Hiki i nā lāʻau ke kumu i ke kiʻekiʻe o ke koko a me ke kiʻekiʻe o ka cholesterol, a hoʻonui i nā pilikia no ka maʻi kō.

Pono kahi transplant kūleʻa i ka ukali pili ʻana me kāu mea hāʻawi. Pono ʻoe e ʻai mau i kāu lāʻau e like me ke kuhikuhi.

Hoʻoiho Hepatic; Transplant - ake; Ka hoʻoliʻiliʻi ate Orthotopic; Hewa ke kōpaʻa - ke ake o ke ake; Cirrhosis - hoʻoliʻiliʻi ate

• Pākuʻi ake hānai
• Ka hoʻoneʻe ʻana i ke ake - series

Carrion AF, Martin P. Kaʻi hou ʻana o ke ake. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 97.

ʻO Everson GT. Hewa Hepatic a me ka lawe ʻana o ke akepaʻa ma: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 145.