Abohlukeneyo amalungu kunye namalaphu. Abohlukeneyo eRussia

ilungu ingxaki yokunqongophala kuba abohlukeneyo ungxamisekile ukuba lonke uluntu luphela. Malunga 18 abantu kufa yonke imihla ngenxa yokungabikho amalungu abanikelayo kunye namalaphu ethambileyo, kwaye silindele ithuba labo. Abohlukeneyo kweli hlabathi mihla le nxalenye ezininzi ezenziwe ngabantu abafileyo, ngubani ngexesha lokudla kwakhe zisayiniwe amaxwebhu afanelekileyo kwemvume yabo Umnikelo emva kokufa.

Yintoni abohlukeneyo

Abohlukeneyo na ukususwa kwamalungu okanye kwizihlunu ezithambileyo le angabaxhasi kunye idlulisele ukuba kumamkeli. Eyona ndlela iphambili ye abohlukeneyo na abohlukeneyo ebalulekile amalungu - oko kukuthi, abo amagunya, ngaphandle apho ubukho akunakwenzeka. Ezi amalungu ziquka intliziyo, izintso kunye nemiphunga. Nangona nezinye izigqeba ezifana injeke, buyisela therapy replacement. Ukususela namhlanje, Silindele ezinkulu sokongezelela ubomi bomntu unika abohlukeneyo. Abohlukeneyo Kuye wayekwenza ngempumelelo. Olu tshintsho intliziyo, izintso, isibindi, lengqula nobubovu, inwebu, udakada, imiphunga, imithambo yegazi, ulusu, intlala kunye ithambo ukudala inkqubo-sikhokelo ngenjongo inyama entsha idale kwixesha elizayo. Kuba okokuqala esinye sezintso ukuphelisa etsolo ukusilela kwezintso isigulane lwaqhutywa ngo-1954, kuchaza namawele afanayo. Abohlukeneyo eRashiya ekuqaleni lwaqhutywa yi Academician Petrovskim B. V. ngo-1965.

Zeziphi ezi ntlobo zahlukeneyo abohlukeneyo

Kwihlabathi kukho abantu abagulela ukufa abaninzi kangaka ezifuna ukufakelwa izibilini kwizihlunu ezithambileyo kunye neendlela zamandulo zokugcinwa unyango kwesibindi, izintso, umphunga, intliziyo, ukunika isiqabu sexeshana kuphela, kodwa musa ukutshintsha ngokwesiseko imeko yesigulane. Abohlukeneyo ikhona ntlobo ezine. Eyokuqala kuzo - allotransplantation - kwenzeka kwimeko xa abanikelayo kunye umamkeli basonta zohlobo olufanayo, kwaye udidi lwesibini xenotransplantation - izifundo zozibini bangamalungu iintlobo ezahlukeneyo. Kwimeko apho abohlukeneyo izicwili okanye amalungu akhutshwa namawele afanayo okanye izilwanyana ephakanyiswe ngenxa lokukhwela consanguineous, umsebenzi kuthiwa izotransplantatsiey. Kule meko ezimbini zokuqala, umamkeli bangase izihlunu ukungafunwa, nto leyo ibangelwa wokhuselo omzimba ephilayo kwiiseli angaphandle. Kwaye lwemizekelo zeethishu ezinxulumene ngokuqhelekileyo aphumelele ngcono. Uhlobo lwesine luquka autotransplantation - tissue kuhlwayelwe kwaye amalungu ngaphakathi emzimbeni.

ubungqina

Njengoko yokusebenza ibonisa, impumelelo imisebenzi kubangelwa ubukhulu becala ukuba isigulo kwangethuba kunye nokuzimisela oluchanileyo ubukho Izimo, kwakunye amalungu yotyando lwaqhutywa kwangexesha. Abohlukeneyo kufuneka singaliqikelela imeko yomguli phambi ukusebenza nasemva. Uphawu esingundoqo ahlinzwe ubukho iziphene asikuko nokuba kuyabulala, izifo kunye ezimbi ezingenako aphathwe iindlela zonyango kunye ngotyando, kwakunye zisongele ubomi yesigulane. Xa abohlukeneyo ebantwaneni into ebaluleke kakhulu kukuba ukumisela ixesha kangangoko ukuze uqhaqho. Ngokutsho iingcali leziko njengoko Institute of abohlukeneyo, nokunqanda utyando akufuneki izakwenziwa ixesha ngokungenangqiqo elide, njengoko ukulibaziseka kuphuhliso umzimba abaselula isiba mandundu. Abohlukeneyo iboniswe kwimeko ALS ubomi obububo emva ukusebenza ngokuxhomekeke ukuma ngezifo.

Abohlukeneyo izitho nezihlunu

Xa abohlukeneyo, lo autotransplantation kunayo yonke, kuba akubikho kubekhona kunye inyama ukwaliwa. Kwimisebenzi ezininzi kuqhutywa abohlukeneyo eluswini, ijwabu adipose kunye izihlunu, intlala, amaqhekeza ithambo, imithambo-luvo, pericardium. ngemithambo yandile kunye ukufakelwa nemithambo. Oku kwenziwe imibulelo kunokwenzeka kuphuhliso microsurgery mihla kunye nezixhobo ezi njongo. Impumelelo enkulu abohlukeneyo na abohlukeneyo leenzwane ukuya unyawo phezu brush. Xa abohlukeneyo autologous kwakhona kuquka ukutofelwa igazi lakhe kunye nokopha kakhulu xa kusenziwa utyando. Xa allograft rhoqo zilinywe lomongo wethambo, imithambo yegazi, inyama ithambo. Eli qela yezinto igazi zizalamane. Ngokuphawulekayo wayengazenzi abohlukeneyo utyando yobuchopho, okoko nje lo msebenzi ujongene nobunzima kakhulu, kodwa ukutshintshwa amacandelo ngamnye isilwanyana kwenziwa ngempumelelo. nepancreas ukufakelwa ikuvumela ukuba uyeke uphuhliso yezigulo ezifana ezifana nesifo seswekile. Kwiminyaka yakutshanje, 7-8 ngo-10 imisebenzi ayaphumelela. Ngelo xesha akazange zilinywe ngokupheleleyo umzimba wonke, kodwa kuphela inxalenye - iiseli esigcwele ezibangela insulin.

Umthetho abohlukeneyo kwi Russian Federation

Ngomhla kummandla ushishino esinye ilizwe lethu lilawulwa nguMthetho we-Russian Federation ukusuka 22.12.92 "Xa abohlukeneyo amalungu kunye (okanye) inyama yabantu". ERashiya, amaxesha amaninzi nokufakelwa kidney, ngamanye amaxesha intliziyo, isibindi kuthwalelwa phandle. yelungu esinye mthetho iqwalasela lo mba njengendlela ukusindisa ubomi kunye nempilo yabemi. Nangona kunjalo, le mithetho iphambili iqwalasela ekulondolozweni ubomi ngumnikeli malunga nempilo yomamkeli. Ngokutsho uMthetho Federal kwi abohlukeneyo of Amaziko, izinto kuba lomongo wethambo, intliziyo, lung, zezintso, isibindi kunye nezinye izigqeba zangaphakathi kunye namalaphu. Ukususwa amalungu ingaqhuba ngathi ngumntu ophilayo, kunye abangasekhoyo. Abohlukeneyo wenziwa kuphela ngemvume ebhaliweyo kumamkeli. Abanikelayo ukuze kuphela abantu abanezakhono abaya kuba befumene axilongwe. Abohlukeneyo eRashiya lwenziwa ngaphandle kwentlawulo, njengoko intengiso amalungu akuvumelekanga ngumthetho.

Abanikelayo abohlukeneyo

Ngokutsho Institute of abohlukeneyo, umntu ngamnye abe ngenxa yentlawulo nokufakelwa amalungu omzimba. Kuba abantu abangaphantsi kweminyaka elishumi elinesibhozo ubudala, kufuneka imvume yabazali nokusebenza. Xa ngokusayina imvume organ izipho emva kokufa Uxilongo kunye novavanyo lonyango, nto leyo evumela ukuba ngawaphi amalungu nga zilinywe. Ngaphandle kuluhlu abanikelayo for nokufakelwa amalungu omzimba kunye nabakhi zeethishu lwe-HIV, isifo seswekile, umhlaza, isifo sezintso, intliziyo kunye nezinye izinto ezimbi kakhulu. A abohlukeneyo enxulumene yenziwa idla ngokuba amalungu bafundelane ngezibini - kwizintso, umphunga, yaye amalungu unpaired - isibindi, kwesisu, injeke.

Izimo ukuba abohlukeneyo

Abohlukeneyo has ezinye Izimo ngenxa yobukho kwezifo ezinokuthi mandundu ngenxa ukusebenza kunye nobomi yomguli sibasongela, kuquka ezibulalayo. Zonke Izimo bohlulwa babe ngamaqela amabini: ngokugqibeleleyo isalamane. Ngu ingundoqo ziquka:

• Izifo ezosulelayo kwamanye amalungu belingana kunye nabo baceba ukuba endaweni, kuquka ubukho sephepha, AIDS;
• ukuphazamiseka ukusebenza amalungu kubalulekile, umonakalo inkqubo luvo central;
• imihlaza;
• ubukho malformations neziphene yokuzalwa, awahambelani nobomi.

Nangona kunjalo, ngexesha kwamalungiselelo utyando ngenxa unyango kunye ukuphelisa iimpawu ezininzi Izimo elililo Kwathi kudidi kwisalamane.

nezintso

Eyona nto ibaluleke ngokukodwa amayeza ithatha esinye zezintso. Ukusukela ukuba oku ilungu bafundelane ngezibini, oko liyasuswa onikelayo anayenza ukuphazamiseka andingowasemzimbeni, ezisongela ubomi bakhe. Ngenxa awohluke wegazi unikezelo kwi kidney zilinywe iyaphila abamkeli kakuhle. imifuniselo yokuqala nokufakelwa zezintso yenziwa kwizilwanyana ngo-1902, isazinzulu uphando E. Ullman. Xa ukufakelwa kumamkeli, nkqu kungekho unyango inkxaso ukuthintela ukwaliwa liqumrhu langaphandle waphila kancinane ngaphezu kweenyanga ezintandathu. Ekuqaleni, lo kidney zilinywe ethangeni, kodwa kamva kunye nophuhliso utyando zabanjwa uqhaqho abohlukeneyo kwindawo yakhe zangasese, le ndlela kwenziwa kule mini. Ukufakelwa kwezintso yokuqala lwenziwa ngo-1954 phakathi namawele afanayo. Emva koko kwaqhutywa-1959 I-ukucikideka a kidney esinye amawele emaqandeni, yaye ubuchule okuthintela ukulahlwa sihlume, kwaye kukho ubungqina bokuba ngempumelelo practice. izixhobo ezitsha zinokuyithintela zendalo omzimba, kuquka azathioprine uyaziwa, leyo ayisayicinezeli umzimba omzimba aye aqatshelwa. Ukususela ngoku phambili abohlukeneyo baye baba immunosuppressants kabanzi.

imizimba zolondolozo

Naliphi na iziko kubalulekile, nto leyo ilungiselelwe abohlukeneyo ngaphandle igazi kunye oxygen ixhomekeke utshintsho vuhlayiseki, emva kokuba kucingwa ukuba angakulungeli abohlukeneyo. Ngokuba onke amalungu, eli xesha ibalwa ngeendlela ezahlukeneyo - kuba intliziyo, ixesha ulinganiswa imizuzu, ibe kidney - iiyure ezimbalwa. Ngoko ke, into engundoqo abohlukeneyo kukugcina amalungu nokugcina intsebenzo lokususa phezulu yabo kwenye ephilayo. Ukusombulula le ngxaki, sebenzisa lokunkonkxa, nto leyo unikezele umzimba kunye mpilo zipholile. Kidney ukuze ukwazi ukugcina iintsuku ezimbalwa. ilungu ukugcinwa kungandisa ixesha kuphando kunye nokukhethwa abamkeli.

Ngalinye imizimba emva kokufumana kokuba ngokuyimfuneko phantsi ulondolozo, oku kufakwa kwisingxobo ngumkhenkce okungenazintsholongwane, ngoko ukuqhuba isisombululo preservation okhethekileyo kubushushu degrees 40 Celsius. Amaninzi kusetyenziswa ezi iinjongo isisombululo ebizwa Custodiol. Perfusion luthathwa ingqalelo ngokupheleleyo xa imilomo sihlume vein kuphuma ukubola isisombululo igazi ecocekileyo ngaphandle ukungcola. Emva lo mzimba ibekwe kumxube ulondolozo, okuseleyo kulo mzuzu lo msebenzi.

ukufakelwa sokwala

Xa kuhlwayelwe ukufakelwa kulo umamkeli eziphilayo iba yenjongosenzi impendulo ngumzimba. Ngenxa yoko, umamkeli protective amajoni omzimba asabela ithatha indawo inani iinkqubo kwinqanaba zeselula ezikhokelela ukwaliwa organ zilinywe. Ezi nkqubo zichazwe isizukulwana omzimba donor-ngqo kunye awakwazi ngayo amajoni omzimba yomamkeli. Kukho iindidi ezimbini ukulahlwa - humoral kunye hyperacute. Kwiintlobo etsolo ukuphuhlisa indlela zombini ukwaliwa.

unyango Rehabilitation and immunosuppressive

Ukunqanda le isiphumo icala unyango immunosuppressive imiselwe kuxhomekeke kuhlobo lo msebenzi, iqela yegazi, izinga zokungahambisani ngumxhasi kunye kumamkeli, kwaye imeko yesigulane. Abakuthandayo incinane awayezibona abohlukeneyo ekhoyo Amalungu nezihlunu, njengokuba kulo mzekelo, njengoko umthetho, 3-4 iantigens ukususela 6 idibana. Ngoko ke, umthamo elingaphantsi immunosuppressants. Ukuqhubeka best ubonisa isibindi. Practice ibonisa ukuba umzimba ubonisa unyaka-elishumi ngaphezu elingama emva kotyando ngo-70% yezigulane. indlela elide umamkeli kunye sihlume microchimerism kwenzeka, ukuvumela ixesha ukunciphisa kuqala ithamo immunosuppressants de ukulahlwa ngokupheleleyo kubo.