Ukwenqaba ukufakelwa

Ukwenqatshwa kokufakelwa kuyinqubo lapho amasosha omzimba womamukeli wokufakelwa ehlasela isitho esitshaliwe noma isicubu.

Amasosha omzimba wakho avame ukukuvikela ezintweni ezingaba yingozi, njengamagciwane, ubuthi, futhi kwesinye isikhathi, namaseli omdlavuza.

Lezi zinto eziyingozi zinamaprotheni abizwa ngama-antigen amboza indawo yawo. Ngokushesha nje lapho lawa ma-antigen engena emzimbeni, amasosha omzimba abona ukuthi awaveli emzimbeni walowo muntu nokuthi "angaphandle," futhi awahlasele.

Lapho umuntu ethola isitho komunye umuntu ngesikhathi sokuhlinzwa kokufakelwa kabusha, amasosha omzimba alowo muntu angabona ukuthi awokufika. Lokhu kungenxa yokuthi amasosha omzimba womuntu athola ukuthi ama-antigen asemangqamuzaneni omzimba ahlukile noma "awahambisani." Izitho ezingalingani, noma izitho ezingahambisani kahle ngokwanele, zingadala ukusabela kokumpontshelwa igazi noma ukwenqatshwa kokufakelwa.

Ukusiza ukuvimbela lokhu kusabela, odokotela bathayipha, noma bafanise bobabili abanikelayo bezitho zomzimba kanye nabantu abathola isitho. Lapho ama-antigen afana kakhulu phakathi komnikeli nomamukeli, mancane amathuba okuthi isitho senqatshwe.

Ukuthayipha izicubu kuqinisekisa ukuthi isitho noma izicubu zifana ngangokunokwenzeka nezicubu zomamukeli. Umdlalo imvamisa awuphelele. Abekho abantu ababili, ngaphandle kwamawele afanayo, anama-antigen wezicubu ezifanayo.

Odokotela basebenzisa imithi ukucindezela amasosha omzimba omamukelayo. Inhloso ukuvikela amasosha omzimba ekuhlaseleni isitho esisanda kutshalwa lapho isitho singahambisani kahle. Uma le mithi ingasetshenzisiwe, umzimba cishe ngaso sonke isikhathi uzokwethula impendulo yomzimba futhi ubhubhise izicubu zangaphandle.

Kukhona okunye okuhlukile, noma kunjalo. Ukufakelwa kweCornea akuvamile ukwaliwa ngoba i-cornea ayinalo igazi. Futhi, ukufakelwa kusuka kwelinye iwele elifanayo kuya kwelinye cishe akukaze kunqatshwe.

Kunezinhlobo ezintathu zokwaliwa:

• Ukwenqatshwa kwehypacacute kwenzeka ngemuva kwemizuzu embalwa ukufakelwa lapho ama-antigen engafani nhlobo. Izicubu kufanele zisuswe ngokushesha ukuze umamukeli angafi. Lolu hlobo lokwaliwa luyabonakala lapho umamukeli enikezwa uhlobo olungelona lwegazi. Isibonelo, lapho umuntu enikezwa uhlobo A lwegazi lapho ewuhlobo B.
• Ukwenqatshwa okunamandla kungenzeka nganoma isiphi isikhathi kusuka ngesonto lokuqala ngemuva kokufakelwa kuya ezinyangeni ezintathu ngemuva kwalokho. Bonke abamukeli banenani elithile lokwenqatshwa okunamandla.
• Ukwenqatshwa okungapheli kungenzeka eminyakeni eminingi. Ukuphendula komzimba okuhlala njalo komzimba kulwa nesitho esisha kulimaza kancane izicubu noma isitho esitshalwe kabusha.

Izimpawu zingafaka:

• Umsebenzi wesitho somzimba ungaqala ukwehla
• Ukungakhululeki okuvamile, ukungakhululeki, noma ukugula
• Ubuhlungu noma ukuvuvukala endaweni yesitho (okungajwayelekile)
• Umkhuhlane (onqabile)
• Izimpawu ezinjengomkhuhlane, kufaka phakathi ukugodola, ukuqaqamba komzimba, isicanucanu, ukukhwehlela nokuphefumula okuncane

Izimpawu zincike esithweni esitshaliwe noma izicubu. Isibonelo, iziguli ezenqaba izinso zingaba nomchamo omncane, kanti iziguli ezenqaba inhliziyo zingaba nezimpawu zokwehluleka kwenhliziyo.

Udokotela uzohlola indawo ngaphezulu nangaphezulu kwesitho esifakwe kabusha.

Izimpawu zokuthi isitho asisebenzi kahle zifaka:

• Ushukela wegazi ophakeme (ukufakelwa kwamanyikwe)
• Kukhishwe umchamo omncane (ukufakelwa izinso)
• Ukuphefumula okuncane kanye namandla amancane okuzivocavoca (ukufakelwa kwenhliziyo noma ukufakelwa kwamaphaphu)
• Umbala wesikhumba ophuzi nokopha okulula (ukufakelwa kwesibindi)

I-biopsy yesitho esithwelwe kabusha ingaqinisekisa ukuthi iyenqatshwa. I-biopsy ejwayelekile ivame ukwenziwa ngezikhathi ezithile ukuthola ukwenqatshwa kusenesikhathi, ngaphambi kokuba izimpawu zivele.

Lapho kusolwa ukwenqatshwa kwezitho zomzimba, ukuhlolwa okukodwa noma okuningi okulandelayo kungenziwa ngaphambi kwe-biopsy yomzimba:

• Iskena se-CT esiswini
• I-x-ray yesifuba
• I-echocardiography yenhliziyo
• Izinso arteriography
• Izinso ultrasound
• Ukuhlolwa kweLab kokusebenza kwezinso noma kwesibindi

Inhloso yokwelashwa ukuqinisekisa ukuthi isitho noma izicubu ezifakiwe zisebenza kahle, nokucindezela ukuphendula kwamasosha akho omzimba. Ukucindezela ukuphendula komzimba kungavimbela ukwenqatshwa kokufakelwa kabusha.

Imithi kungenzeka isetshenziselwe ukucindezela ukuphendula komzimba. Isilinganiso nokukhethwa kwemithi kuya ngesimo sakho. Umthamo ungaphakama kakhulu ngenkathi izicubu zenqatshwa. Ngemuva kokuthi ungasenazo izimpawu zokwenqatshwa, umthamo uzokwehliswa.

Okunye ukufakelwa izitho nezicubu kuphumelele kakhulu kunezinye. Uma ukwenqatshwa kuqala, imishanguzo ecindezela amasosha omzimba ingamisa ukunqatshwa. Iningi labantu lidinga ukuthatha le mithi impilo yabo yonke.

Yize imithi isetshenziselwa ukucindezela amasosha omzimba, ukufakelwa kwezitho zomzimba kusengaphumelela ngenxa yokwenqatshwa.

Iziqephu ezilodwa zokwenqatshwa okunamandla azivamile ukuholela ekuhlulekeni kwesitho.

Ukwenqatshwa okungapheli kuyimbangela ehamba phambili yokwehluleka kokufakelwa komzimba. Umzimba ulahlekelwa umsebenzi wawo kancane kancane futhi izimpawu ziyaqala ukuvela. Lolu hlobo lokwenqatshwa alunakwelashwa ngempumelelo ngemithi. Abanye abantu bangadinga okunye ukufakelwa.

Izinkinga zempilo ezingabangelwa ukufakelwa noma ukwenqatshwa kokufakelwa zifaka:

• Eminye imidlavuza (kwabanye abantu abathatha imishanguzo eqinile yokucindezela amasosha omzimba isikhathi eside)
• Ukutheleleka (ngoba amasosha omzimba womuntu ayacindezelwa ngokuthatha imithi ecindezela amasosha omzimba)
• Ukulahlekelwa wumsebenzi esithweni esifakelwe kabusha / kwezicubu
• Imiphumela emibi yemithi, engaba nzima

Shayela udokotela wakho uma isitho esitshalwe kabusha noma izicubu kubonakala kungasebenzi kahle, noma uma kwenzeka ezinye izimpawu. Futhi, shayela udokotela wakho uma unemiphumela engemihle emithini oyiphuzayo.

Ukuthayipha igazi kwe-ABO ne-HLA (tissue antigen) ukuthayipha ngaphambi kokufakelwa kusiza ekuqinisekiseni ukufana okuseduze.

Kuzodingeka ukuthi uphuze umuthi ukucindezela amasosha akho omzimba impilo yakho yonke ukuvimbela ukuthi izicubu zenqatshwe.

Ukuqaphela ukuthatha imithi yakho ngemuva kokufakelwa kabusha futhi ubhekwe kakhulu ngudokotela wakho kungasiza ekuvimbeleni ukwenqatshwa.

Ukwenqatshwa kokuxhunyelelwa; Ukwenqatshwa kwezicubu / izitho zomzimba

• Amasosha omzimba

U-Abbas AK, uLichtman AH, uPillai S.Ukufakelwa komzimba kwe-immunology. Ku: Abbas AK, Lichtman AH, Pillai S, eds. I-Immunology yeselula neyeMolekyuli. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 17.

I-Adams AB, iFord M, iLarsen CP. Ukufakelwa kwe-immunobiology kanye ne-immunosuppression. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa: Isisekelo Sebhayoloji Sokuzijwayeza Kwamanje Kokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 24.

Tse G, Marson L. Immunology yokwenqatshwa kwehlumela. Ku: Forsythe JLR, ed. Ukufakelwa kabusha: Umlingani Wokuzijwayeza Kokuhlinzwa Okuchwepheshe. Umhlaka 5. IPhiladelphia, PA: Elsevier Saunders; 2014: isahluko 3.