An kashe fiye da 500,000 a cikin Amurka
Bisa ga Cibiyar sadarwa ta United Network for Organ Sharing (UNOS), a tsakanin Janairu 1, 1988, da Yuni 30, 2016, kimanin 669,556 anada su a cikin Amurka. Kodayake waɗannan lambobi suna da ban sha'awa sosai, akwai kawai ƙananan gabobin waɗanda suke buƙatar su. A halin yanzu, mutane 120,139 suna buƙatar tsaftattun kwayoyin ceto.
Ga wadansu abubuwa guda shida da suka fi dacewa da juna don su rage yawan mita. Ƙayyadadden ƙwayoyin jiki ne kawai aka ƙayyade domin masu karɓar sakonni sukan karbi kwayoyin fiye da ɗaya a lokaci guda. Alal misali, yawan ƙwayar koda / pancreas (21,727) a lokacin da aka ambata a sama ya fi yawan adadin pancreas kawai (8,235).
1 -
KodaYawan adadin kidney a tsakanin Janairu 1, 1988 da Yuni 30, 2016, ya kasance 395,510
Kodan su ne mafi yawan kwayar da aka sassauka. A shekara ta 2011, akwai masu tarin kaya mai mahimmanci 11,835 da suka mutu da kuma 5772 wadanda suka ba da gudummawa.
Yin amfani da koda aka yi amfani da su don bi da mutanen da ke fama da cutar ta koda, ko gazawar koda. Yawanci, irin wannan rashin nasarar koda ya faru ne saboda ciwon sukari ko hauhawar jini mai tsanani. Ga mafi yawancin, sassan kaya sun fi nasara fiye da haɓaka da kuma inganta rayuwa da kuma kara yawan rai zuwa ga mafi girma fiye da yadda ya dace.
A cikin shekarun 1960, kadai magungunan rigakafin rigakafin da muke da shi don magance ƙin gabobin shine azathioprine da prednisone. Saboda muna da magungunan maganin rigakafi a cikin shekarun farko na dasawa, kodan da aka samu daga masu bada gudummawar rayuwa sun fi dacewa su dauki fiye da kodan da aka samu daga masu bada agaji.
A yau, muna da magunguna daban-daban don taimakawa wajen kawar da amsawa ga mutanen da suka karbi kaya. Musamman, waɗannan kwayoyi suna kare wasu maganin rigakafi, ciki har da waɗanda kwayoyin cutar, fungi, da musacin cutar suka haifar.
Ana amfani da masu amfani da su don ƙin yarda su zama ƙwararru a matsayin mai ɗaukar nau'in shigarwa ko masu aiki . Ma'aikata masu tayar da hankali sun rage damar da aka ƙin yarda kuma an ba su a lokacin dashi. A cikin mutane da ke samun kodan, waɗannan hadewa sun hada da kwayoyin da ke kawar da yin amfani da ko dai kwayoyin steroid ko calcineurin masu hanawa (cyclosporine da tacrolimus) da kuma abubuwan da ke tattare da su.
Tsaran aikin gyare-gyare na taimakawa wajen hana ƙin yarda da asarar koda. Yawanci, marasa lafiya suna karɓar maganin nan: prednisone (steroids), mai sarrafawa calcineurin da antimetabolite (tunanin azithioprine ko, mafi yawan, mycophenolate mofetil). An gyara farfadowa na gyara a tsawon lokaci.
Godiya ga ingantawa a cikin jiyya na rigakafi, asarar kodan da aka sassauki saboda mummunan ƙin yarda shi ne wanda ba a sani ba. A watan Disamba na shekarar 2012, yawan masu karɓar koda da ke cikin rai bayan shekaru biyar, ko kuma shekaru biyar na rayuwa, shine kashi 83.4 na kodan da aka samu daga masu bada agaji da kuma kashi 92 cikin 100 na kodan da aka samu daga masu bayarwa.
Bayan lokaci, duk da haka, aiki na kodan da aka sassauci yana cike da ƙwayar cuta ta hanyar rashin lafiya, wanda ya haɗa da fibrosis na intstitial, atrophy tubular, vasculopathy, da juyayi. Sabili da haka, matsakaicin rai na rayuwa ga wadanda ke karbar kodan daga masu bada gudummawa shine shekaru 20 da kuma cewa ga masu karbar masu ba da gudummawa su ne shekaru 14.
Dole ne mai yardar rai ga masu bayar da agaji masu rai su kasance cikin duk wani mummunan yanayin kiwon lafiya, kuma masu bada agajin da suka mutu ba su da wata cuta da za a iya yada ga mai karɓa, irin su HIV, hepatitis ko ciwon daji.
Masu bada taimako suna daidaita da masu karɓa ta hanyar amfani da antigens na jini (tunanin jini) da kuma antigens na HLA babban tasiri na tarihin tarihi. Masu amfani da kodan da suka fi dacewa da HLA iri sun fi kyau fiye da waɗanda suke da nau'in HLA. Yawancin lokaci, dangi na farko ya fi dacewa su nuna matakan HLA da aka samo antigens. A wasu kalmomi, dangi na farko ya fi dacewa ya samar da kwayar da za ta iya amfani da ita fiye da koda daga wanda ya mutu.
Kwayar aikin tiyata yana da inganci ba tare da kwayar da ake sanyawa a fossa ta jiki ba tare da buƙatar batar da kullun peritoneal. Idan duk yana tafiya lafiya, mai karɓar koda zai iya tsammanin za'a kwashe shi daga asibiti a cikin kyakkyawan yanayin bayan kwana biyar.
Kodan da aka samo daga masu bada agajin marigayin za a iya kiyaye su kimanin awa 48 kafin a dashi. Wannan lokaci yana ba ma'aikatan kiwon lafiya cikakken lokaci don rubutawa, wasan giciye, zaɓi da kuma kai wadannan gabobin.
2 -
HuduYawan adadin hanta a tsakanin Janairu 1, 1988, da Yuni 30, 2016, ya kasance 143,856.
Kamar yadda kodan da kwarewa suka samu, haɗi zai iya zo daga masu bada gudummawa. Kwayar da aka haifa na hanta ya zo ne daga kwakwalwa-masu bada agaji wadanda basu da shekaru 60. Mai ba da gudummawa ya cika wasu ka'idodin, ba tare da lalacewar hanta ba saboda cututtuka ko cututtuka kamar hepatitis.
Masu kwarewa suna daidaita masu bada taimako tare da masu karɓa ta yin amfani da haɗin ABO da girman mutum. Abin sha'awa a lokuta na gaggawa, hanta za a iya raba (raba hanta) kuma an bai wa masu karɓa biyu. Har ila yau a lokuta na gaggawa ko gawarwar gawarwowar alama, za'a iya amfani da masu amfani da ABO. Sabanin da kayan aikin koda, bazai buƙaci a kula da haɗin HLA ba.
Hanta ne kawai ƙungiyar visceral don samun rinjaye mai mahimmanci. A takaice dai, hanta ya sake dawowa. Wannan mawuyacin tsarin mulki shine dalili da yasa za'a iya yin gyaran hanta na hanta. Da zarar an raba wani ɓangare ko lobe na hanta, zai sake mulki.
Tare da hanta na hanta, an sa fibe-haɗin da aka fi girma da yawa a cikin hagu na hagu. Bugu da ƙari kuma, kodayake hawan gwanin hanta ne da aka samo daga masu bada gudummawar rayuwa, an samo yawancin hanta daga kwakwalwa. A shekarar 2012, kashi 4 cikin 100 na karfin hanta ne (246 hanyoyin) aka samo daga masu bada gudummawa.
An miƙa shinge na noma a matsayin hanyar jiyya bayan an gama sauran sauran zaɓuɓɓuka. An miƙa wa mutane da cututtukan hanta mai tsanani da rashin karɓuwa waɗanda babu wanda za a iya samun likita ko magani. Alal misali, mutumin da ke da ciwon cirrhosis wanda ke haifar da cutar hepatitis C ko kuma maye gurbi zai iya zama dan takara don haɓaka hanta.
Tare da hawan hanta, lokaci yana da matukar muhimmanci. Mutumin da yake karbar dashi dole ne yayi rashin lafiya don buƙatar shuka amma ya isa ya warke daga tiyata.
Dukkanin hanta, ko tsire-tsire kothotopic , wata babbar tiyata ne da ƙalubalen fasaha-musamman ma a mutanen da ke dauke da hauhawar jini wanda nau'in cirrhosis ya sabawa. Haɗuwa da hauhawar jini da kuma coagulopathy, ko kuma gurgunta jini wanda ke haifar da rashin cin hanci, zai iya haifar da yawan jini yayin da ake aiki da kuma buƙatar jini. Bugu da ƙari, don cire dukan hanta sannan kuma maye gurbin shi na buƙatar farko (yankan) sannan kuma anastomoses (shiga) na manyan jini da sauran sifofi, irin su ƙananan ƙarancin ƙananan ƙwayoyin cuta, ƙwaƙwalwar ƙwayar ƙafa, ƙwaƙwalwar ƙwayar cuta, da kuma ƙwayar bile.
3 -
ZuciyaYawan adadin zuciya a tsakanin Janairu 1, 1988, da Yuni 30, 2016, ya kai 64,085.
Don maye gurbin zuciya wani abu ne wanda mafarkin masana kimiyya ya yi mafarki, amma mun yi hakan. Ya ɗauki fiye da shekaru 200 don cigaba a fahimtar mu game da ilimin rigakafi da kuma inganta aikin tiyata da kuma fasaha da fasaha don bude kofa don dashi. A shekara ta 1967, an yi kwaskwarima a Cape Town, Afirka ta Kudu, wanda likita mai suna Dr Christiaan Barnard ya yi.
Kodayake fasaha na fasaha, tsinkayen zuciya na farko ba su tsawanta rayuwa ba a kowace hanya. A gaskiya ma, Barnard yayi haƙuri ne kawai kwanaki 18 bayan samun sabon zuciya. Zai ɗauki ingantaccen kwayoyi da kwayoyin rigakafin da ke yin amfani da su don inganta zaman rayuwa bayan tayar da zuciya.
Bisa ga Ma'aikatar Kiwon Lafiya ta Amurka da Ayyukan Dan Adam, a shekara ta 2012, shekarun shekaru biyar na rayuwa, ko yawan mutanen da suke da rai har shekaru biyar bayan kwashe zuciya, kashi 76.8 ne.
4 -
LungKwayar da aka shuka a tsakanin Janairu 1, 1988, da Yuni 30, 2016, shine 32,224.
Tun daga shekara ta 1985, an yi amfani da dashi fiye da 40,000 a duniya. Ana aiwatar da shinge a cikin mutanen da ke fama da cutar kututturewa wanda ba shi da mummunan rauni. Ga waɗannan alamomi guda huɗu na alamun daji na sutura:
- Hanyar hana cutar huhu (COPD)
- Idiopathic na huhu fibrosis
- Cystic fibrosis
- Alpha-1 antitrypsin rashi emphysema
Yawanci, ana samo huhu daga matacce masu bada agaji tare da ciwon kwakwalwar kwakwalwa (ƙwaƙwalwar kwakwalwa). Duk da haka, tsakanin 15 zuwa 20 bisa dari na irin waɗannan masu bada agaji suna da ƙwayoyin da za su dace da dashi.
Ga mafi yawan cututtukan da ke bada izinin suturar ƙwayar zuma, ko dai ɗaya ko biyu ƙwayoyin za a iya transplanted. Tare da cystic fibrosis da sauran siffofin bronchiectasis, duk da haka, duka huhu suna buƙatar a sake su. Ana yin gyare-gyaren duka biyu don dakatar da kamuwa da cuta daga yada daga ƙwayar ƙwayar ƙwayar cuta zuwa jikin jikin daji. Kodayake za'a iya canza kogi biyu ko biyu don magance mafi yawan cututtukan cututtuka, ana cire nau'in ƙwayoyin ƙwayar biyu.
An raba ƙwayar dama a cikin lobes guda uku, kuma yatsun hagu ya raba zuwa lobes biyu. Canji na lobe da aka samo daga mai ba da gudummawar rayuwa an yi shi a baya amma yanzu ba a sani ba. Yawancin lokaci, irin wannan shinge na lobar an yi a matashi da matasa tare da cystic fibrosis wanda zai mutu yayin da yake jiran wani sashi na dangi (ko sau biyu) wanda aka samo shi daga mai ba da gudummawa.
Yawanci, ingancin rayuwa ya inganta alama a cikin waɗanda ke karbar suturar jikin huhu. Ainihin lokacin da mutumin ke rayuwa tare da dashi ya bambanta bisa ga abin da cutar ta haifar da dashi da kuma shekarun mai karɓa - tare da ƙarami masu karɓar rayuwa tsawon lokaci-da kuma dashi. A cikin sharuddan magana, mutane da yawa da suka karbi tsutsaran huhu sun rayu a kusa da shekaru 10 kafin haguwar kin amincewa ba zai yiwu ba.
5 -
PancreasYawan rassan katako a tsakanin Janairu 1, 1988, da Yuni 30, 2016, ya kasance 8,235.
Kashi na farko da aka kirkiro shi ne William Kelly da Richard Lillehei a Jami'ar Minnesota a shekarar 1966. Tun daga wannan lokacin, an gudanar da ayyukan girka fiye da 25,000 a Amurka da sama da 35,000 a duniya. Yawanci, ana samun raguwa daga masu bada agajin da suka mutu; duk da haka, koda yake a yanzu ba za a iya amfani da su, masu ba da gudummawa ba za a iya amfani da su.
Rashin shinge shi ne magani na tsawon lokaci ga mutanen da ke fama da ciwon sukari masu ciwon sukari (type 1 diabetes mellitus). Irin wannan canji zai iya mayar da gurbin gina jiki na glucose na al'ada da kuma metabolism da kuma rage haɗarin rikice-rikice na lokaci na biyu zuwa ga ciwon sukari.
Daga bayanin kula, ana amfani da tsire-tsire-tsire-tsire-tsire-tsalle tare da isasshen transplants , waɗanda basu da kishi. Kwayoyin islet ne gungu na kwayoyin halitta a cikin jikin da ke samar da kwayoyin hormones, kamar insulin da glucagon. Kodayake tarihin tsire-tsire sun inganta sosai a cikin 'yan shekarun nan, aikin gyaran gyaran ƙwayar cuta ya fi kyau fiye da isassun transplants. Maimakon tsari na gwagwarmaya, ya fi dacewa don duba ƙuƙwalwar katako da ƙaddarar ƙira a matsayin hanyoyin haɗaka, wanda duka zasu iya taimakawa mai karɓa a buƙata.
6 -
IntestineYawan tarin hanzarin intestine tsakanin Janairu 1, 1988, da Yuni 30, 2016, ya kasance 2,733.
Canji na hanji shine hanya mai rikitarwa. A cikin 'yan shekarun nan, wannan hanya ta sami karɓuwa a wajen maganin ciwon ƙwayar ciwo, wanda mutane ba za su iya sha ruwa mai yawa, calories, sunadaran, mai, bitamin, ma'adanai da sauransu ba. Yawancin lokaci, mutanen da suka karbi hanzarin zuciya suna shafar rashin cin zarafi na ainihi kuma suna buƙatar cikakken abincin jiki parenteral (TPN), ko abincin mai gina jiki.
Kusan kashi 80 cikin dari na mutanen da suka karbi zane-zane na ciki sun sami cikakkiyar aiki a cikin sutura na hanji. Matsalolin da suka shafi wannan hanya sun hada da kamuwa da CMV , m da ƙin yarda, da kuma cutar lymphoproliferative post-transplant.
Sources:
Azzi J, Milford EL, Sayegh MH, Chandraker A. Canji a cikin Jiyya na Lalacewar Renal. A: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Ka'idodin Magungunan Ciki na Harrison, 19th. New York, NY: McGraw-Hill; 2015.
Gruessner AC, Jie T, Papas K, Porubsky M, Rana A, Smith M, Yost SE, L. Dunn D, Gruessner RG. Canji. A: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. Ka'idodin Harkokin Tiyata na Schwartz, 10th . New York, NY: McGraw-Hill; 2014.
Tavakkoli A, Ashley SW, Zinner MJ. Ƙananan ƙwayar cuta. A: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. Ka'idodin Harkokin Tiyata na Schwartz, 10th . New York, NY: McGraw-Hill; 2014.
Tsarin Gida ta Tsarin Gida Janairu 1, 1988 - Yuni 30, 2016. Ƙungiya ta Ƙungiya ta Ƙungiya ta Musayar https://www.unos.org/data/.
Trulock EP. Tsuntsu mai layi. A: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Ka'idodin Magungunan Ciki na Harrison, 19th . New York, NY: McGraw-Hill; 2015.