Kukonzekera kwa mtima ndi mankhwala a golidi ochizira kwa odwala omwe ali ndi mtima wolephera-kutanthauza kuti palibe chithandizo chabwino. Koma sizabwino. Madokotala omwe amasamalira odwalawa nthawi zonse amafunafuna njira zopititsira patsogolo chithandizo.
Nkhani yabwino ndi yakuti anthu ambiri omwe amafunika kusintha kwa mtima amapeza-kwa zaka zambiri, odwala 2,000 mpaka 2,500 okha pa chaka adalandira mtima watsopano.
Mu 2015, nambala imeneyo inakwera kufika 2,804. Mu 2016, idabweranso ku 3,191.
Mwamwayi, mitima yambiri yathanzi imaperekedwa pofuna kutsimikizira kuti aliyense amene akufuna mtima watsopano amalandira imodzi. Madokotala akuyang'ana njira zomwe angaganizire ntchito yothandizira ziwalo kotero kuti omwe ali pachiopsezo chachikulu ayambe kuikidwa.
Chifukwa Chake Wina Amafunika Kujambula Mtima
Anthu okwana 5.7 miliyoni ku US akuvutika ndi mtima wolephera. Izi zikutanthauza kuti mitima yawo sitingakhoze kupopera molimba monga momwe ayenera, kawirikawiri chifukwa cha kuwonongeka kwa mtima, kuthamanga kwa magazi, shuga, valve yopunduka, kapena matenda a mtima otchedwa cardiomyopathy. Anthuwa amawona zizindikiro zomwe zingaphatikizepo kupuma pang'ono, kutopa, kutaya madzi okwanira m'milingo ndi mavoti, komanso kupuma kupumula.
Odwala mtima akudwala amafunika mankhwala kuti athandize mitima yawo kugwirizanitsa kwambiri, kuthetsa madzi owonjezera, komanso kuwonjezera magazi.
Mankhwalawa akhoza kuchepetsa kukula kwa mtima, kuwachotsa kuchipatala, ndi kuwaletsa kuti asafe. Koma patapita nthawi, mankhwala amatha kugwira ntchito. Panthawi imeneyi, kukweza mtima kungakhale njira yokhayo.
Ndani Ayenera Kujambula Mtima?
Zotsatira za omwe akuyeneretsa kuika mtima ndi omwe sali ovuta.
Malo onse opatsirana amadzipangira okha omwe odwala angatenge.
Kuchepetsa matenda oopsa kwambiri ndi chimodzi mwa zinthu zokha zomwe zimachititsa kuti wodwalayo asatengeke. Kuwonjezera apo, malo ambiri samapatsa mtima mwa wodwala amene sangathe kutenga mankhwala omwe akuwafuna atachita opaleshoni pofuna kuteteza mtima wawo watsopano. Malo ambiri amafunikanso kuti okhwima asakhale ndi mankhwala osokoneza bongo komanso mowa kwa zaka ziwiri asanatenge mtima, komanso kusuta kwa nthawi.
Palibe cutoff ya zaka zowonjezera mtima, koma:
- Theka la odwala omwe amalandira mtima watsopano ali ndi zaka 50 mpaka 64. Anthu a m'badwo uwu amayamba kuchita bwino ndipo amatha kuyembekezera kukhala ndi moyo zaka 10 mpaka 11 chifukwa atenga mankhwala awo otsutsa.
- Akuluakulu omwe ali ndi zaka makumi asanu ndi awiri (70) ali pachiopsezo chachikulu, chifukwa ali ndi matenda ena.
- Odwala omwe ali ndi zaka zapakati pa zaka makumi awiri ndi makumi awiri (20s) amayamba kukhala otenga chiopsezo ndipo nthawi zambiri amasiya kumwa mankhwala awo otsutsa. Akachita, zotsatira zingakhale zoopsa.
- Ana omwe amafunika kusintha kwa mtima amayamba kuchita bwino chifukwa chitetezo cha mthupi chawo chiri pansi pa chitukuko ndipo makolo amaonetsetsa kuti amamwa mankhwala awo.
Kupewa Kutanidwa
Mankhwala otsutsa amaletsa chitetezo cha mthupi, choncho thupi silingayang'ane mtima watsopano monga thupi lachilendo ndikuwuukira.
Kwa zaka, cyclosporine idagwiritsidwa ntchito pofuna kupewa kukanidwa. Masiku ano, 90 peresenti ya odwala amagwiritsa ntchito tacrolimus.
Chifukwa tacrolimus ndi yamphamvu komanso yowonjezera, zochepa zimathandiza kupewa kukana komwe kumachepetsa zotsatirapo. Komabe, odwala omwe sagonjera mtima wopereka-akuluakulu, amuna, ndi / kapena caucasian-nthawi zambiri amachita bwino ndi mankhwala ofooka.
Kuika Pampu Yamagetsi
Pokhala ndi mitima yowonjezera yokwanira yopitilira, kugwiritsa ntchito makina opangidwa ndi mawotchi monga moyo wamuyaya m'malo mwawo akukambirana. Zipangizo zothandizira zowonjezera (VADs) ndi mitima yowonongeka nthawi zambiri amagwiritsidwa ntchito kanthawi kuti athandize mtima wolephera pamene wodwala akudikirira ("Bridge Bridge to Transplant").
Wodwala aliyense ali ndi imodzi mwa zipangizozi amalowa mu Interagency Registry for Supported Circulatory Support (INTERMACS). M'kupita kwa nthawi, chidziwitso chomwe chatsopanochi chikuthandizira madokotala kudziwa ngati zipangizo zogwiritsira ntchito zingakhale njira zabwino komanso zothandiza kwa mtima wa munthu.
Mphatso Yathupi
Kumene mukukhala kumakhudza mwayi wanu wolandira mtima watsopano kapena kufa musanakhale mtima. Chiwerengero cha imfa pamene tikudikira kuti tizilumikizako chimasiyana ndi dziko kuchokera pa magawo atatu mpaka 22 peresenti. Odwala omwe amakhala kutali ndi malo oyandikana nawo a mtima wokhala ndi mtima wochepetsetsa amakhala ochepa kwambiri kuposa omwe amakhala pafupi. Koma iyi si nkhani yonse.
Pakalipano, kuyembekezera odwala amaikidwa m'magulu akuluakulu ndipo amasiyana ndi mtundu wa magazi, kukula, ndi zaka. Pali chidwi chodziwikitsa zomwe zimapangitsa wodwalayo kukhala ndi chiopsezo chochuluka cha kufa asanalandire mtima. Izi zikhoza kulola mitima yopezeka kwa odwala odwala poyamba, ziribe kanthu komwe akukhala.
Komabe, chosowa cha mitima kuchokera kwa opeza bwino, ochepa apitilizabe kupitiliza kupereka. Mungathe kuthandiza polembetsa kuti mukhale wothandizira pano ndipo muwone bokosi pa layisensi yanu yoyendetsa galimoto. Ngakhale mutakhala okalamba kwambiri kuti musapereke mtima pa nthawi ya imfa yanu, maso, khungu, kapena ziwalo zina zingapindule munthu mmodzi kapena anthu ambiri.
Dr. Hsich ndi katswiri wa zamaganizo amene amadziwika kwambiri ndi kusintha kwa mtima. Iye ndi Mtsogoleri Wachiyanjano wa Zamankhwala ku Cleveland Clinic Heart Transplant Program, ndi Mtsogoleri wa kliniki ya Kulephera kwa Mtima wa Women.