Kunzwisisa Zvinokurudzira uye Zvikwereti zveChiropa Kuiswa
Chiropa chinoputika dzimwe nguva chinongorapwa kurapa kune vanhu vane chirwere chakaoma kana chisingaperi chechiropa. Kufambira mberi mune chiropa kushandiswa kwakaguma nehuwandu hunotarisira hupenyu huripo, uye 58% yevakagamuchira vanopona kwemakore gumi nemashanu.
Chiropa chinoputika chakatanga kuitwa kumakore ekuma1960, kunyange zvazvo zvichinyanya kuongororwa kusvika pakati pe1980 apo pakanga paine nzira dzakanakisisa dzekuvhiya uye nzira dzakanakisisa dzekudzivirira chigamba chekuregererwa kwenhengo.
Nhasi, zvinopfuura 6 000 zvechiropa zvinoputika zvinowanikwa gore negore.
Kukurudzira Zvikonzero zveChiropa Kupindira
Nokuti chiropa chinodhura chinodhura uye chinotakura ngozi huru, vanachiremba vanokurudzira ivo sechinhu chokupedzisira. Izvi zvinowanzoitika apo chiropa hachisisiri kushanda, uye zvinetso kubva mukukuvara kwechiropa hazvigoni kudzora.
Pakati pezvikonzero zvakajairika zvekuvhara chiropa:
- End-strost cirrhosis kubva kune chero chinokonzera, kusanganisira chirwere chechipatara B kana C, chirwere chinodhaka chinokonzera doro, uye chisina kunyanyisa mafuta chiropa chechiropa. Kunyange zvazvo cirrhosis pachayo isiri chiratidzo chekugadziriswa, zviratidzo zvekubhadharisa (zvakadai sekuchecherapathy, kuchenesa ropa, kana kukwira kwepamusoro ) zvinogona kushanda sechishuvo.
- Zvimwe zvirwere zveropa zveropa , inlcuding cholangiocarcinoma, hepatocellular carcinoma (HCC), primary hepatocellular malignancies uye hepatic adenomas.
- Kukanganiswa kwechirwere cheFulminant kubva kune imwe yezara yakazara hepatitis (A, B, D uye kazhinji C), kusapindwa kwemishonga kunokonzera kusakundikana, chirwere chepfungwa, chirwere chaWilson kana zvimwe zvinokonzera.
- Dysfunction yakanyanya ye bile bile, inokonzerwa ne-biliary cirrhosis uye sclerosing cholangitis.
Kufanirwa kweChiropa Kupindira
Hazvishamisi kuti vanhu vakawanda vanoda chiropa chinopfurikidza pane izvo zvinowanikwa kuti zviwedzere. Nemhaka yeizvi, vadzidzisi vezvehutano hwehutano vakagadzira muenzaniso weMuenzaniso wekupedzisira-Stage Chiropa Disease (MELD) chikamu , chigadziriso chinoshandisa kuongorora kuoma kwechirwere chechirwere chisingaverengeki uye kubatsira rubatsiro rwevatachiona kwekugadziriswa.
Dzimwe nzira dzokugadzirisa dzinogona kushandiswa, kusanganisira Mitsara yeMilan , iyo inokodzera munhu zvichienderana nekukura uye / kana nhamba yezvipembenene zvechiropa (kureva, kwete kukura kupfuura masentimita mashanu, kana zvisingasviki matatu matatu akaenzana kana kuti pasi 3 masentimita muhukuru).
Kunyange zvazvo kuchinja kunogona kuonekwa sekushanda kune chero chinhu chakaoma kana chisingaperi chinokonzera kusagadziriswa uye kusingaperi kwechiropa chisingaiti, kunogona kuwanzova nhamba yezvipingamupinyi pakuita sarudzo.
Sangano iri muUnited States rinotarisirwa kuenzanisa vanhu vane zvivako zviripo ndeye United Network for Organ Sharing (UNOS). Sangano risina purogiramu rinoshanda pasi pechibvumirano chehurumende yeHurumende kuenzanisa uye kupa nhengo.
Contraindications for Liver Transplantation
Contraindications for chiropa chekuisa kune avo vanogona kuwedzera mukana wekufa kune anogamuchirwa kana kuti zvichizoguma nekukundikana kana kurambwa kwekuiswa. Pakati pezvimwe zvinopesana zvachose zvekushandura:
- Ikozvino doro kana zvinodhaka zvinodhaka
- Dambudziko remoyo kana mapapu
- Cancers (kwete kusanganisira chirwere chepachiropa kana che-non-melanoma yechirwere cheganda)
- Dzakawanda uye dzakawanda kuberekwa kukanganisa kunogona kutungamirira kukufa kusati kwasvika
- Zvimwe zvirwere zvisina kudzora kana zvirwere zvinopisa upenyu
Panewo zvimwe zvinopesana zvakasiyana , izvo zvinodanwa nokuti zvinogona kana zvisingabvumirano kurapwa zvichienderana nekuongorora kweimwe kana zvimwe zvinhu, kusanganisira:
- Zera rakapfurikidza (yakwegura kupfuura makore 65)
- Kuora kweiyo
- Kuderedza kuora
- Kusanyanya kusagadzikana
- HIV (kunyange zvisinganyanyi kukosha kune varwere vane utachiona hwehutachiona huripo)
- Yakakura pulmonary hypertension
- Yakasimba, isingadzorwi (kana isina kutorwa) matambudziko epfungwa
Sources:
American Liver Foundation. "Zvimwe Nezvokupa Mupi." New York, New York; yakarongedzwa naJanuary 15, 2015.
Duffy, J .; Vardanian, A .; Benjamin, E .; et al. "Liver Transplantation Criteria For Hepatocellular Carcinoma Inofanira Kuwedzerwa." Annals of Surgery. Svondo 2007; 246 (3): 502-511.
Iruzubieta, P .; Crespo, J .; uye Fabrega, E. "Kupona Kwenguva Yakareba Shure Kwechiropa Kuchengetwa kweAlcoholic Liver Disease." World Journal of Gastroenterology. December 28, 2013; 19 (48): 9198-9208