Ke kuʻi ʻōpū

ʻO ke kāpili ʻana i ka maʻi he ʻōpū e hoʻololi i hoʻokahi a i ʻole ʻelua mau maʻi i loaʻa i ka maʻi me nā maʻi olakino olakino mai kahi mea hāʻawi kanaka.

I ka hapanui o nā hihia, hāʻawi ʻia ka māmā hou a i ʻole nā ​​mumū e kahi kanaka ma lalo o 65 mau makahiki a ua make ka lolo, akā ke kākoʻo nei ke ola. Pono nā maʻi hāmeʻa e maʻi ʻole a kūlike i ka hiki ke hiki i kāu ʻano kiko. Hoʻoemi kēia i ka manawa e hōʻole ai ke kino i ke transplant.

Hiki ke hāʻawi ʻia i nā puʻupuʻu e nā mea hāʻawi ola. Pono ʻelua a ʻoi paha poʻe. Hāʻawi kēlā me kēia kanaka i kahi ʻāpana (lobe) o ko lākou māmā. Hana kēia i kahi māmā āpau no ka mea e loaʻa ana iā ia.

Ma ke kahakaha transplant lung, hiamoe ʻoe a ʻaʻohe ʻeha (ma lalo o ka anesthesia ākea). Hana ʻia kahi ʻokiʻoki ma ka umauma. Hana pinepine ʻia ke kāpili transplant lung me ka hoʻohana ʻana o ka mīkini puʻuwai puʻuwai. Hana kēia mea hana i ka hana o kou puʻuwai a me kou mau māmā ʻoiai e ku ana kou puʻuwai a me nā māmā no ke ʻoki.

• No nā transplants lung hoʻokahi, hana ʻia ka ʻoki ma ka ʻaoʻao o kou umauma kahi e lawe ʻia ai ka māmā. Hana ka hana i 4 a 8 mau hola. I ka hapanui o nā hihia, hemo ka lung me ka hana ʻoi loa.
• No nā transplants lung papalua, hana ʻia ka ʻoki ma lalo o ka umauma a hiki i nā ʻaoʻao ʻelua o ka umauma. Lawe ke ʻoki kino i 6 a 12 mau hola.

Ma hope o ka ʻoki ʻana, nā hana nui i ka wā o ke kāpili transplant lung me:

• Kau ʻia ʻoe ma ka mīkini puʻuwai puʻuwai.
• Wehe ʻia hoʻokahi a ʻelua paha o kou mau māmā. No ka poʻe e loaʻa ana i kahi transplant lung papalua, ka hapa nui a i ʻole nā ​​ʻanuʻu mai ka ʻaoʻao mua i hoʻopau ʻia ma mua o ka pau ʻana o ka ʻaoʻao ʻelua.
• ʻO nā kīʻaha koko nui a me nā ala ea o ka māmā hou i humuhumu ʻia i kāu mau kīʻaha koko a me kou ala ea. Kuʻi ʻia ka lobe a i ʻole ka lung i kahi. Hoʻokomo ʻia nā paipu umauma e hoʻokahe i ka ea, ka wai, a me ke koko mai ka umauma no kekahi mau lā e ʻae i nā ake māmā e hoʻonui hou.
• Lawe ʻia ʻoe mai ka mīkini puʻuwai puʻuwai ke humuhumu ʻia nā māmā a hana.

I kekahi manawa, hana ʻia nā transplants puʻuwai a me nā māmā i ka manawa like (transplant puʻuwai-lung) inā maʻi ka puʻuwai.

I ka hapanui o nā hihia, hana ʻia kahi transplant lung ma hope o nā kūleʻa ʻē aʻe āpau no ka kūleʻa ʻole ʻana o ka maʻi. Hiki ke ʻōlelo ʻia nā transplants paru no nā poʻe ma lalo o ka makahiki 65 i loaʻa i nā maʻi maʻi māmā. ʻO kekahi mau laʻana o nā maʻi e koi ai i kahi transplant lung:

• ʻO Cystic fibrosis
• Ka poino i nā aʻa o ka māmā ma muli o kahi kīnā i ka puʻuwai i ka hānau ʻana (hemahema)
• Ka luku ʻia ʻana o nā ala nui a me nā māmā (bronchiectasis)
• Emphysema a i ʻole ka maʻi pulmonary maʻi ākea (COPD)
• Nā kūlana lung kahi e pehu ai nā mākala a me ka ʻulaʻula (interstitial lung disease)
• ʻO ke koko kiʻekiʻe i nā aʻa o nā akemā (hypertension pulmonary)
• ʻO Sarcoidosis

ʻAʻole hiki ke hana i ke kanu ʻōpū no ka poʻe:

• He maʻi nui a hānai maikaʻi ʻole paha e hele i ke kaʻina hana
• E hoʻomau i ka puhi a hōʻino paha i ka waiʻona a i ʻole nā ​​lāʻau ʻē aʻe
• Loaʻa iā hepatitis B ikaika, hepatitis C, a i ʻole HIV
• Loaʻa i ka maʻi ʻaʻai i loko o 2 mau makahiki i hala
• Loaʻa i ka maʻi lung e hiki paha ke hoʻololi i ka lung hou
• Loaʻa i ka maʻi nui o nā mea ʻē aʻe
• ʻAʻole hiki ke hilinaʻi i kā lākou lāʻau
• ʻAʻole hiki ke hoʻomau i ka haukapila a me nā kipa mālama olakino a me nā hoʻokolohua e pono ai

ʻO nā pōʻino o ka lawe ʻana i nā māmā me:

• Koko koko (thrombosis venous hohonu).
• ʻO ka maʻi diabetes, ka lahilahi iwi, a i ʻole nā ​​pae kolesterol kiʻekiʻe mai nā lāʻau i hāʻawi ʻia ma hope o kahi transplant.
• Hoʻonui i ka makaʻu no nā maʻi ma muli o nā lāʻau anti-rejection (immunosuppression).
• Poino i kou puʻupaʻa, ake, a i ʻole nā ​​mea ʻē aʻe mai nā lāʻau anti-rejection.
• ʻO ka hopena o kekahi mau maʻi maʻi i ka wā e hiki mai ana.
• Nā pilikia ma kahi o nā kīʻaha koko hou i hoʻopili ʻia.
• ʻO ka hōʻole ʻana i ka hū hou, hiki ke hana koke ʻia ia, ma loko o ka 4 a 6 mau pule, a i ʻole ka hala ʻana o ka manawa.
• ʻAʻole holo iki paha ka lung hou.

E loaʻa iā ʻoe nā hoʻokolohua aʻe e hoʻoholo ai inā he moho maikaʻi ʻoe no ka hana.

• Nā ho'āʻo koko a i ʻole nā ​​hoʻāʻo ʻana o ka ʻili e nānā ai no nā maʻi
• Kikokiko kikokiko
• Nā ho'āʻo e loiloi i kou puʻuwai, e like me electrocardiogram (EKG), echocardiogram, a i ʻole catheterization naʻau
• Nā hoʻāʻo e loiloi i kāu mau māmā
• Nā hoʻāʻo e nānā ai i ka maʻi ʻaʻai mua (Pap smear, mammogram, colonoscopy)
• ʻO ka kikokiko ʻana i ka mūlū, e kōkua e hōʻoia i ka hōʻole ʻole o kou kino i ka māmā i hāʻawi ʻia

Hoʻokomo ʻia nā moho maikaʻi no ke transplant i kahi papa inoa kakali āpana. Hoʻokumu ʻia kāu wahi ma ka papa inoa kali i nā kumu he nui, e like me:

• He aha nā ʻano pilikia o kou mau māmā
• ʻO ke koʻikoʻi o kou maʻi maʻi
• ʻO ka likelika e kūleʻa kahi transplant

No ka hapanui o nā mākua, ʻo ka nui o ka manawa āu e lilo ai i ka papa inoa kali e ʻike pinepine ʻole i ka loaʻa koke o ka lung. Ke kali pinepine ka manawa kali ma 2 a 3 mau makahiki.

ʻOiai ʻoe e kali nei i kahi puʻupuʻu hou:

• E hāhai i nā papaʻai āpau a kāu kime transplant lung i paipai ai. E hōʻoki i ka inu ʻona ʻana, mai puhipaka, a mālama i kou kaupaona i ka pae i koi ʻia.
• E lawe i nā lāʻau āpau e like me ka mea i kauoha ʻia. Hōʻike i nā loli i kāu mau lāʻau a me nā pilikia olakino he mea hou a ʻoi aku paha ka maikaʻi i ka hui transplant.
• E hāhai i kekahi papahana hoʻoikaika kino i aʻo ʻia iā ʻoe i ka wā o ka hoʻoponopono pulmonary.
• Mālama i nā manawa āu i hana ai me kāu lawelawe mālama ola maʻamau a me ka hui transplant.
• E hoʻomaopopo i ka hui transplant pehea e hoʻopili koke aku ai iā ʻoe inā loaʻa kahi māmā. E ʻike pono hiki ke kiʻi koke aku iā ʻoe a maʻalahi hoʻi.
• E hoʻomākaukau mua e hele i ka haukapila.

Ma mua o ke kaʻina hana, e haʻi mau i kāu mea hāʻawi:

• He aha nā lāʻau, nā wikamina, nā mea kanu, a me nā mea hoʻopili ʻē aʻe āu e lawe nei, ʻo nā mea āu i kūʻai ai me ka ʻole o ka lāʻau
• Inā inu ʻoe i ka waiʻona he nui (ʻoi aku i hoʻokahi a ʻelua paha mau inu i ka lā)

Mai ʻai a inu ʻole i kekahi mea ke haʻi ʻia ʻoe e hele i ka haukapila no kāu transplant lung. Lawe wale i nā lāʻau i ʻōlelo ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.

Pono ʻoe e noho i ka haukapila no 7 a 21 mau lā ma hope o ka lawe ʻana o ka māmā. E hoʻolōʻihi paha ʻoe i ka manawa ma ke keʻena mālama nui (ICU) ma hope pono o ke kaha ʻana. ʻO ka hapa nui o nā kikowaena e hana ana i nā transplants lung he mau ʻano maʻamau no ka mālama ʻana a me ka mālama ʻana i nā mea maʻi transplant lung.

ʻO ka wā hoʻōla e pili ana i 6 mau mahina. ʻO ka manawa pinepine, e noi ana 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 kahi transplant lung kahi hana nui e hana ʻia no nā poʻe me ka maʻi maʻi a hoʻoweliweli i ke ola.

Ma kahi o ʻehā o ʻelima mau maʻi e ola nei i ka makahiki 1 ma hope o ke transplant. Ma kahi o ʻelua o ʻelima mau mea lawe transplant e ola nei ma 5 mau makahiki. ʻO ka makaʻu kiʻekiʻe loa o ka make ma ka makahiki mua, ka nui o nā pilikia e like me ka hōʻole ʻana.

ʻO ka hakakā ʻana i ka hōʻole he hana hoʻomau ia. Manaʻo ka ʻōnaehana pale o ke kino i ka mea i hoʻoulu ʻia ma ke ʻano he invader a kūʻē paha iā ia.

I mea e pale aku ai i ka hōʻole ʻana, pono nā mea maʻi transplant i nā lāʻau lapaʻau anti-rejection (immunosuppression). Hoʻopau kēia mau lāʻau i ka pale o ke kino a hoʻemi i ka manawa o ka hōʻole. ʻO ka hopena, eia nō naʻe, hoʻemi kēia mau lāʻau i ka hiki kūlohelohe o ke kino e hakakā i nā maʻi.

Ma o 5 mau makahiki ma hope o ka hoʻoliʻiliʻi ʻana o ka hanu, ma ka liʻiliʻi hoʻokahi o ʻelima mau kānaka e hoʻomohala i nā maʻi ʻaʻai a i ʻole pilikia me ka puʻuwai. No ka hapanui o ka poʻe, hoʻomaikaʻi ʻia ke ʻano o ke ola ma hope o ka lawe ʻana i ka māmā. He hoʻomanawanui hoʻoikaika kino maikaʻi kā lākou a hiki ke hana i nā mea hou aʻe i kēlā me kēia lā.

Ke kuʻi ʻōpū paʻa - lung

• Ke kuʻi ʻōpū - moʻo

ʻO Blatter JA, Noyes B, Sweet SC. Ke kanu hou ʻana o ka pēpē Pediatric. I: Wilmott RW, Deterding R, Li A, et al. nā ʻaoʻao Nā maʻi o Kendig o ke ala hanu i nā keiki. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 67.

ʻO Brown LM, Puri V, Patterson GA. Ka hoʻoneʻe ʻana i ka lepa. I: Sellke FW, del Nido PJ, Swanson SJ, eds. ʻO Sabiston lāua ʻo Spencer Surgery o ka umauma. 9th ed. Piladelapia, PA: Elsevier; 2016: chap 14.

Chandrashekaran S, Emtiazjoo A, Salgado JC. ʻO ka mālama nui ʻana i nā mea maʻi transplant lung. I: ʻO Vincent J-L, ʻo Abraham E, Moore FA, Kochanek PM, Fink MP, eds. Puke aʻo o ka mālama koʻikoʻi. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 158.

ʻO Kliegman RM, Stanton BF, St. Geme JW, Schor NF. Pediatric puʻuwai a me ka puʻuwai-transplantation. I: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 20 ouk. Piladelapia, PA: Elsevier; 2016: chap 443.

ʻO Kotloff RM, Keshavjee S. Lung transplantation. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray & Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 106.