Ukufakelwa KwamaPancreas

-Delile

• Ngabe kunezinhlobo ezingaphezu kweyodwa zokufakelwa kwamanyikwe?
• Ngubani onikela ngamanyikwe?
• Kuzothatha isikhathi esingakanani ukuthola amanyikwe?
• Kwenzekani ngaphambi kokufakelwa kwamanyikwe?
• Ukufakelwa kwamanyikwe kwenziwa kanjani?
• Kwenzekani ngemuva kokufakwa kokufakwa kwamanyikwe?
• Ingabe zikhona izingozi ezihambisana nokufakelwa kwamanyikwe?
• Yini okuthathwayo kothile ocabanga ukufakelwa amanyikwe?

Kuyini ukufakelwa kwamanyikwe?

Yize kuvame ukwenziwa njengesinqumo sokugcina, ukufakelwa kwamanyikwe sekuyindlela yokwelapha ebalulekile kubantu abanesifo sikashukela sohlobo 1. Ukufakelwa kwamanyikwe kwesinye isikhathi kwenziwa kubantu abadinga ukwelashwa kwe-insulin futhi bane-type 2 yesifo sikashukela. Kodwa-ke, lokhu akuvamile kakhulu.

Ukufakelwa kokuqala kwamanyikwe womuntu kwaqedwa ngo-1966. I-United Network for Organ Sharing (UNOS) ibika ukuthi kwenziwe ukufakelwa okungaphezu kwama-32,000 e-United States phakathi kukaJanuwari 1988 no-Ephreli 2018.

Inhloso yokufakelwa kabusha ukubuyisela amazinga ejwayelekile eglucose egazini emzimbeni. Ama-pancreas atshalwe kabusha akwazi ukukhiqiza i-insulin ukuphatha amazinga kashukela egazini. Lona ngumsebenzi amanyikwe akhona womfakisicelo wokufakelwa angeke esakwazi ukwenza kahle.

Ukufakelwa kwamanyikwe kwenziwa ikakhulukazi kubantu abanesifo sikashukela. Ngokuvamile ngeke isetshenziselwe ukwelapha abantu abanezinye izimo. Akuvamile ukwenziwa ukwelapha umdlavuza othile.

Ngabe kunezinhlobo ezingaphezu kweyodwa zokufakelwa kwamanyikwe?

Kunezinhlobo eziningana zokufakelwa kwamanyikwe. Abanye abantu bangaba nokufakelwa kwamanyikwe wedwa (i-PTA). Abantu abane-nephropathy yesifo sikashukela - ukulimala kwezinso ezinesifo sikashukela - bangathola amanyikwe nezinso zabaxhasi. Le nqubo ibizwa ngokuthi ukufakelwa kwamanyikwe i-pancreas-kidney (SPK) ngasikhathi sinye.

Izinqubo ezifanayo zifaka amanyikwe ngemuva kwezinso (PAK) nezinso ngemuva kokufakelwa kwamanyikwe (KAP).

Ngubani onikela ngamanyikwe?

Umnikeli wama-pancreas uvamise ukuba ngumuntu omenyezelwe njengofile ebuchosheni kepha uhlala emshinini osekela impilo. Lo mnikeli kufanele ahlangabezane nenqubo ejwayelekile yokufakelwa, kufaka phakathi ukuba neminyaka ethile nokuphila okunempilo.

Ama-pancreas omnikeli nawo kufanele ahambisane nokuvikelwa komzimba nomzimba womamukeli. Lokhu kubalulekile ukusiza ukunciphisa ingozi yokwenqatshwa. Ukwenqatshwa kwenzeka lapho amasosha omzimba womamukeli esabela kabi kusitho esinikelwe.

Ngesinye isikhathi, abaxhasi be-pancreatic bayaphila. Lokhu kungenzeka, isibonelo, uma umamukeli wokufakelwa angathola umnikeli oyisihlobo esiseduze, njengewele elifanayo. Umnikeli ophilayo unikeza ingxenye yamanyikwe, hhayi isitho sonke.

Kuzothatha isikhathi esingakanani ukuthola amanyikwe?

Kunabantu abangaphezu kuka-2 500 ohlwini lokulinda uhlobo oluthile lokufakelwa kwamanyikwe e-United States, kuphawula i-UNOS.

Ngokusho kukaJohns Hopkins Medicine, umuntu ojwayelekile uzolinda unyaka owodwa noma emibili ngaphambi kokuba kwenziwe i-SPK. Abantu abathola ezinye izinhlobo zokufakelwa, njenge-PTA noma i-PAK, bazohlala ngaphezulu kweminyaka emibili ohlwini lokulinda.

Kwenzekani ngaphambi kokufakelwa kwamanyikwe?

Uzothola ukuhlolwa kwezokwelapha esikhungweni sokufakelwa ngaphambi kwanoma yiluphi uhlobo lokufakelwa komzimba. Lokhu kuzobandakanya ukuhlolwa okuningi ukuthola impilo yakho yonke, kufaka phakathi ukuhlolwa komzimba. Uchwepheshe wezokunakekelwa kwempilo esikhungweni sokufakelwa uzophinde abuyekeze umlando wakho wezokwelapha.

Ngaphambi kokuthola ukufakelwa kwamanyikwe, izivivinyo ezithile ongase ubhekane nazo zifaka:

• ukuhlolwa kwegazi, njengokuthayipha igazi noma ukuhlolwa kwe-HIV
• iX-ray yesifuba
• ukuhlolwa kwezinso
• izivivinyo ze-neuropsychological
• izifundo zokubheka ukusebenza kwenhliziyo yakho, njenge-echocardiogram noma i-electrocardiogram (EKG)

Le nqubo yokuhlola izothatha inyanga eyodwa kuya kwezimbili. Umgomo ukuthola ukuthi ungumuntu olungele yini ukuhlinzekwa nokuthi uzokwazi yini ukuphatha uhlobo lwemithi ngemuva kokufakelwa kabusha.

Uma kunqunywa ukuthi ukufakelwa kuzokufanele, khona-ke uzobekwa ohlwini lokulinda lesikhungo sokufakelwa.

Khumbula ukuthi izikhungo ezahlukahlukene zokufakelwa kungenzeka zibe nezinqubo ezihlukile zokuhlinza. Lokhu kuzohluka ngokuya ngohlobo lomnikeli nempilo yonke yomamukeli.

Ukufakelwa kwamanyikwe kwenziwa kanjani?

Uma umnikeli engasekho, udokotela wakho ohlinzayo uzosusa amanyikwe kanye nengxenye enamathiselwe emathunjini abo amancane. Uma umnikeli ephila, udokotela wakho ohlinzayo uvame ukuthatha ingxenye yomzimba nomsila wamanyikwe.

Inqubo ye-PTA ithatha cishe amahora amabili kuya kwamane. Le nqubo yenziwa ngaphansi kwe-anesthesia ejwayelekile, ngakho-ke umamukeli wokufakelwa uqulekile ngokuphelele ukuze angabuzwa ubuhlungu.

Udokotela wakho ohlinzayo usika maphakathi nesisu sakho bese ubeka izicubu zomnikeli esiswini sakho esingezansi. Bazobe sebenamathisela isigaba esisha somathumbu omncane womnikeli oqukethe amanyikwe (kusuka kumnikeli ongasekho) emathunjini akho amancane noma kumanyikwe (kusuka kumnikeli ophilayo) esinyeni sakho somchamo bese benamathisela amanyikwe emithanjeni yegazi. Ama-pancreas akhona omamukeli ngokuvamile ahlala emzimbeni.

Ukuhlinzwa kuthatha isikhathi eside uma izinso ziphinde zatshalwa ngenqubo ye-SPK. Udokotela wakho ohlinzayo uzonamathisela i-ureter yezinso zabaxhasi esinyeni nasemithanjeni yegazi. Uma kunokwenzeka, ngokuvamile bazoshiya izinso ezikhona endaweni yazo.

Kwenzekani ngemuva kokufakwa kokufakwa kwamanyikwe?

Ngemuva kokufakelwa kabusha, abamukeli bahlala egumbini labagula kakhulu (i-ICU) ezinsukwini ezimbalwa zokuqala ukuvumela ukuqapha okusondele kunoma yiziphi izinkinga. Ngemuva kwalokhu, bavame ukuthuthela endaweni yokululama ukufakelwa ngaphakathi esibhedlela ukuze ilulame ngokwengeziwe.

Ukufakelwa kwamanyikwe kuhilela izinhlobo eziningi zemithi. Ukwelashwa kwezidakamizwa komamukeli kuzodinga ukuqapha okubanzi, ikakhulukazi ngoba bazothatha inani lale mithi nsuku zonke ukuvimbela ukwenqatshwa.

Ingabe zikhona izingozi ezihambisana nokufakelwa kwamanyikwe?

Njenganoma ikuphi ukufakelwa kwezitho zomzimba, ukufakelwa kwamanyikwe kuthwala ithuba lokwaliwa. Kubuye kube nengozi yokwehluleka kwamanyikwe uqobo. Ingozi kule nqubo ethile iphansi kakhulu, ngenxa yentuthuko ekwelashweni kwemithi yokuhlinza ne-immunosuppressant. Kukhona nengozi yokufa ehambisana nanoma yikuphi ukuhlinzwa.

Umtholampilo waseMayo uphawula ukuthi isilinganiso seminyaka emihlanu sokusinda kokufakelwa kwamanyikwe cishe singamaphesenti angama-91. Ngokusho kuka-a, ingxenye yempilo (ihlala isikhathi eside kangakanani) yokufakelwa kwamanyikwe ekufakelweni kwe-SPK okungenani iminyaka eyi-14. Abaphenyi baqaphela ukuthi ukusinda okuhle kakhulu kwesikhathi eside komamukeli kanye nokuxhunyelelwa kwamanyikwe kulolu hlobo lokufakelwa kungenziwa ngabantu abane-type 2 yesifo sikashukela futhi asebekhulile.

Odokotela kufanele balinganise izinzuzo zesikhathi eside nezingozi zokufakelwa kabusha ngokumelene nezinkinga namandla okufa ahlobene nesifo sikashukela.

Inqubo uqobo inezingozi eziningana, ezifaka ukopha, amahlule egazi, kanye nokutheleleka. Kukhona futhi ingozi eyengeziwe ye-hyperglycemia (ushukela ophakeme wegazi) owenzeka ngesikhathi nangemva kokufakelwa.

Izidakamizwa ezinikezwa ngemuva kokufakelwa nazo zingadala imiphumela emibi kakhulu. Abamukeli bokufakelwa kufanele bathathe eminingi yale mithi isikhathi eside ukuvimbela ukwenqatshwa. Imiphumela emibi yale mithi ihlanganisa:

• cholesterol ephezulu
• umfutho wegazi ophakeme
• i-hyperglycemia
• ukuncipha kwamathambo (i-osteoporosis)
• ukulahleka kwezinwele noma ukukhula ngokweqile kwezinwele kwabesilisa noma kwabesifazane
• ukuzuza kwesisindo

Yini okuthathwayo kothile ocabanga ukufakelwa amanyikwe?

Kusukela ukufakelwa kwamanyikwe okokuqala, kube nenqubekela phambili enqubeni eminingi. Le ntuthuko ifaka phakathi ukukhethwa okungcono kwabaxhasi bezitho zomzimba kanye nokwenza ngcono ukwelashwa kwama-immunosuppressant ukuvimbela ukwaliwa kwezicubu.

Uma udokotela wakho enquma ukufakelwa kwamanyikwe kuyindlela efanelekile kuwe, inqubo iyoba yinkimbinkimbi. Kepha lapho ukufakelwa kwamanyikwe kuphumelela, abamukeli bazobona ukuthuthuka kwikhwalithi yabo yokuphila.

Khuluma nodokotela wakho ukunquma ukuthi ukufakelwa kwamanyikwe kukufanele yini.

Abantu abacabanga ukufakelwa isitho futhi bangacela ikhithi yolwazi nezinye izinto zamahhala ezivela ku-UNOS.