Kuti mumvetsetse momwe zimakhalira ndikugwiritsanso ntchito mankhwala osakanikirana, ndi bwino kumvetsetsa zowonongeka kokha, komanso mfundo zina zokhudzana ndi chitetezo cha m'thupi, mitundu yosiyanasiyana ya ogwira ntchito, komanso momwe zinthu ziwirizi zingapangidwire.
Kodi Kusindikiza Ndi Chiyani?
Kuika ndi njira yachipatala komwe minofu kapena chiwalo chimachotsedwa ku thupi limodzi ndikuziika mu thupi lina kuti zikhazikitse chiwalo kapena minofu yomwe ikugwira ntchito bwino, ilibe, kapena yodwala.
Kupatsirana kwa thupi kumangotenga matenda okhaokha. Izi sizichitika pazirombo zochepa kapena zochepa, zimachitika pamene liwalo liri ndi matenda kotero kuti potsirizira pake amatsogolera ku dialysis kapena imfa popanda kuika.
Zomwe zimafala kwambiri zimatengedwa ndi kutenga limba kuchokera ku thupi limodzi la munthu, lokhala ndi moyo kapena lakufa, ndikulowetsedwa mu thupi lina laumunthu. Mankhwala, ziphuphu monga khungu, mitsempha, ndi matope, ndipo ngakhale cornea yomwe ili m'diso ikhoza kubwezedwa ndikupatsidwa kwa wolandira kuti athetse nkhani zosiyanasiyana.
N'zotheka kupiranso zinyama zamtundu, monga nkhumba kapena ng'ombe, ndi kuzigwiritsa ntchito kwa munthu wolandira. Imodzi mwa njira zodziwika kwambiri zomwe minofu imeneyi ingagwiritsidwe ntchito ndi odwala omwe amafunikira valve ya mtima m'malo mwake.
Zakale, ziwalo za kuikidwa m'mthupi zidatengedwa kuchokera ku thupi limodzi ndikuikidwa mu thupi lina laumunthu. Pakhala pali zizolowezi zochepa zomwe ziwalo zimachotsedwera ku primate ndikuikidwa mwa wolandira munthu.
Mwa amenewa, wotchuka kwambiri ndi Stephanie Fae Beauclair wa 1984, yemwe amadziwika bwino kuti "Baby Fae," amene adalandira mtima wa nyama zamphongo ali ndi zaka khumi ndi zisanu ndi chimodzi asanamwalire ali ndi zaka 31.
Mitundu ya Kusuntha
Pali mitundu yambiri ya kusintha ndi mndandanda wa njira zambiri zofotokozera njira zomwe zimapangidwira.
Kuopsa kwa kukanidwa kumasiyanasiyana pakati pa mitundu ya opereka, popeza kusiyana pakati pa wopereka ndi wobwezera kungawonjezere mwayi wokanidwa. Pa chifukwa chimenechi, kumvetsetsa chikhalidwe cha kuikapo kungawathandize kupeza chiopsezo cha kukanidwa ndipo kungathandize ngakhale gulu la thanzi labwino kuti liwone momwe mankhwala amafunikira kuti ateteze kukanidwa.
Pano pali mndandanda wafupikitsidwe wa mawu omwe amagwiritsidwa ntchito pa mitundu yosiyanasiyana ya mapiritsi.
Autograft: minofu imatengedwa kuchokera kumbali imodzi ya thupi ndi kuikidwa mu gawo lina la thupi lomwelo. Mwachitsanzo, atapsa kwambiri, wodwalayo akhoza kukhala ndi khungu lachitsulo kamene amachotsedwa pamlendo wawo. Izi zimapangitsa mwayi wochiritsidwa bwino, ndipo nkhani zotsutsa sizikhalapo pomwe wopereka ndi wolandirayo ali anthu ofanana.
Allograft: Mtengowu umakhala munthu wopangidwa ndi ziwalo, ziwalo, kapena corneas. Woperekayo ndi munthu wosiyana ndi wolandira ndipo sangathe kukhala wofanana (monga mapasa ofanana). Pali chiopsezo chodziwika cha kukanidwa ndi mtundu uwu wa kuikidwa kwa thupi.
Isograft: Kuika kotereku kumachitika pakati pa wopereka zowonongeka ndi wolandira, monga mapasa ofanana.
Palibe chifukwa chokana kukanidwa mu nkhani iyi, pamene thupi silizindikira kuti liwu lofanana ndi lachilendo ndilolendo.
Xenograft: Kuyika kotereku ndiko pakati pa mitundu yosiyanasiyana . Izi ndi mitundu yofesa, monga bulu kwa anthu kapena nkhumba kwa anthu. Kawirikawiri, izi ndizopangidwa minofu koma nthawi zambiri zimakhala ziwalo za thupi. Pali kuyembekezera kwa chiopsezo chachikulu ndi mtundu uwu wa kuikidwa komatu, koma nthawi zambiri mawonekedwe a minofu amapereka chiopsezo chochepa cha kukanidwa.
Mitundu ya Opereka Donyo
Pali mitundu itatu ya othandizira bungwe.
Cadaveric Donor: matenda a munthu wakufayo, ziwalo, ndi / kapena corneas amawomboledwa kukhala wolandira munthu wamoyo.
Mphatso yotereyi ili ndi chiwopsezo chomwecho ngati wopereka wina wosagwirizanitsa kupatula ngati kuyesa kwa chibadwa kumapangitsa mgwirizano pakati pa wopereka ndi wobwezera bwino kuposa momwe zimakhalire.
Zowonjezera zowonjezera: Wopereka munthu wamoyo amapereka limba kwa wachibale yemwe akusowa kuika thupi. Kuika pamtunduwu kungakhale kosavuta kukanidwa chifukwa cha kufanana kwa chibadwa pakati pa wopereka ndi wolandira.
Altruistic Donor: Wopereka wamoyo akusankha kupereka liwu kwa wothandizira wosagwirizana. Mphatso yotereyi ili ndi msinkhu wofanana wokonzedwa ngati wopereka winanso wosagwirizana pokhapokha wopereka ndi wolandirayo atakhala wabwino kwambiri.
Kukana Kwadongosolo
Mitundu yambiri yomwe imachitika ku United States ndizopangidwa minofu . Izi zimatha kukhala mafupa, mitsempha, matope, magetsi a mtima, kapenanso ngakhale khungu. Kwa ovomerezekawa pali uthenga wabwino kwambiri: iwo sangathe kukanidwa kwambiri ndi ziwalozi .
Kwa ovomerezeka ndi ziwalo, kukana chiwalo chatsopano ndi vuto lafunika kotero kuti kumafuna kufufuza kawirikawiri kudzera mu ntchito ya magazi, mankhwala tsiku ndi tsiku, komanso ndalama zambiri. Kukana kumatanthauza kuti thupi limakana chiwalo chatsopano chifukwa chikuwona kuti ndiwowononga wamba ngati ofanana ndi matenda osayenera. Kukhoza kukanidwa ndiko kawirikawiri kudera nkhaŵa chifukwa chokanizidwa chifukwa kukanidwa kungatanthawuze kubwerera ku dialysis mankhwala kapena ngakhale imfa chifukwa cha kulephera kwa thupi.
Mmene Chitetezo cha Mthupi chimagwirira ntchito
Chitetezo cha m'thupi chimakhala chovuta komanso chovuta kwambiri, ndipo nthawi zambiri chimakhala ndi ntchito yodabwitsa yosunga thupi la munthu. Chitetezo cha mthupi chimapanga zinthu zambiri, kuteteza thupi ku mavairasi, majeremusi, ndi matenda komanso kuthandiza kuchiritsa. Kuwuza kuti chitetezo cha mthupi ndi chovuta kwambiri, ndiye kuti mabuku onse amalembedwa pa chitetezo cha mthupi komanso momwe amatetezera thupi.
Pokhapokha chitetezo cha mthupi, sitidzakhala ndi khanda ngati sitidzatha kulimbana ndi tizilombo toyambitsa matenda ngakhale pang'ono kuzizira. Chitetezo cha mthupi chimatha kuzindikira chomwe chiri "chokha" ndipo chiri m'thupi ndipo chimatha kuzindikira zomwe ziri "zina" ndikuzimenyana nazo.
Kachitidwe kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kawiri kanali kovuta kwambiri. Nthawi zambiri chitetezo cha mthupi sichiteteza zinthu kuti zisalowe m'mapapo kapena m'magazi kapenanso kutulutsa matenda, koma ndizopambana kwambiri pomenyana nawo.
Chitetezo cha mthupi chimayambitsanso mavuto pamene chimadziwoneka kuti "chokha". "Mtundu uwu wa vuto limatchulidwa kuti" matenda okhaokha "ndipo amachititsa matenda aakulu monga lupus, multiple sclerosis, ulcerative colitis, mtundu wa shuga , ndi nyamakazi ya nyamakazi. Matendawa ndi omwe amachititsidwa ndi chitetezo cha mthupi chikuyambitsa popanda chifukwa, ndipo zotsatira zingakhale zowawa.
Njira ya Immune ndi Kukaniridwa Kwagulu
Pankhani ya kusintha kwa thupi, vuto lalikulu-pambuyo popeza limba loyenerera kuikapo mankhwala-ndikosunga chiwalo chatsopano mwa kuchiletsa kukanidwa. Izi zimachitika ndi mankhwala, kapena mankhwala ambiri, omwe amathandiza kupusitsa thupi kuti lizindikire "zina" monga "kudzikonda." Mwachidule, chitetezo cha mthupi chiyenera kuganiza kuti chiwalo chatsopano chiri gawo la thupi, osati chiwalo chomwe siili.
Kuwongolera chitetezo cha mthupi ndi chovuta kuposa momwe zingamveke chifukwa thupi ndi lofunika kwambiri pozindikira othawa chifukwa ndilofunikira pamoyo. Kwa anthu ambiri, chitetezo cha mthupi chimakula kwambiri komanso chimakhala champhamvu kwambiri pazaka zoyambirira za moyo ndipo chimatha kuthetsa matendawa chaka chilichonse ndikukhala wamkulu.
Kafukufuku akuthandizira anthu omwe amatha kupambana pa nkhondo yolimbana ndi kukanidwa, kuphatikizapo kugwidwa ndi matenda, pogwiritsa ntchito momwe chitetezo cha mthupi chimatchulira thupi ndi chiwalo monga "zina" pambuyo pa kusamba. Kupeza ndondomeko yeniyeni ya chitetezo cha mthupi kumayambitsa njira zambiri zotsutsa kumatanthawuza kuti potsiriza njira yothetsera izo zingathe kulengedwa.
Kodi N'chiyani Chimayambitsa Kukana kwa Thupi?
Zimakhulupirira kuti kukhalapo kwa chiwalo kumatchulidwa poyamba kuti "zina" pamene SIRP-alpha protein imamangiriza ku cholera chaching'ono pa selo loyera la magazi. Kuchokera pamenepo, kumapezeka chingwe chomwe chingawathandize kukana thupi lonse ngati sichigwidwa mu nthawi kapena ngati mankhwala sagonjetsedwe.
Ochita kafukufuku amawonetsa kuti monga mitundu ya magazi, padzakhala mitundu ya SIRP-alpha, ndipo poyesa woperekayo ndi wolandirayo akhoza kuchepetsa chiopsezo chokanizira asanayambe opaleshoni pochitidwa pofanana ndi mtundu wopereka ndi wolandira SIRP-alpha. Izi zikhoza kuchepetsa chiopsezo chachikulu cha kukanidwa, kuchepetsa kuchuluka kwa mankhwala omwe akuyenera kuti athe kupewa kukanidwa, ndipo koposa zonse, kuthandizani limba kukhala nthawi yaitali kwa wolandira.
Kuchepetsa Kuopsa kwa Kukanidwa Musanayambe Kusamba
Pali kale njira zambiri zomwe mwayi wotsutsa umachepa usanachitike opaleshoni, choyamba makamaka poonetsetsa kuti wolandirayo ndi woperekayo ali ndi mitundu yowonjezera ya magazi, ndikupitirizabe kuyesa ndi njira zowonjezereka.
Ngati woperekayo ndi wopereka moyo, wachibale nthawi zambiri amakonda chifukwa mwayi wa kukanidwa umachepa. Tingapeze mtsogolo kuti izi ndichifukwa chakuti mabanja ali bwino kufanana ndi SIRP-alpha, koma panthawi ino ndi lingaliro limodzi.
Kuyesedwa kwa majeremusi kumathandizidwenso kuti apange mgwirizano wabwino wopereka wopereka. Izi ndizofunikira makamaka ndi kusintha kwa impso, monga zofanana zotsatizana zimabweretsa zaka zambiri zogwirira ntchito.
Yembekezerani kuti muwone kafukufuku omwe amathandiza kupanga maubwenzi abwino pakati pa wopereka ndi wolandira mankhwala, komanso kufufuza kwina kuti mukhale "mbali" yeniyeni ya chitetezo cha mthupi kuti muteteze kukanidwa.
Kuchepetsa Kuopsa Kokukanidwa Pambuyo Kusamalidwa
Pakalipano, atatha kulumikiza limba, zotsatira za labu la wodwala ndi mtundu wa kuikapo zidzakuthandizira kupanga mtundu wa mankhwala ndi kuchuluka kwa mankhwala omwe amaperekedwa kuti asatenge kukanidwa.
Mapulogalamuwa adzayang'aniridwa mobwerezabwereza m'masabata ndi miyezi pambuyo pake, ndipo pangakhale kuchepa kwa odwala ambiri chaka choyamba. Komabe, wodwalayo adzaphunzitsidwa kuyang'ana zizindikiro za kukana ndi kukhala maso kuti asunge thanzi lawo.
Kuyang'ana kukanidwa, kusintha mankhwala chifukwa cha kuwopseza kapena kupezeka kwa kukanidwa, ndi kubwereranso kumakhala kofala. Izi zatsimikiziridwa ngati chigawo chotsutsa chikutsatiridwa ndi wobwezeretsa wokhazikika nthawi zonse ayenera kuthana nawo kuti akhalebe ndi thanzi labwino.
M'tsogolomu, ngati kupita patsogolo kwa chitetezo cha chitetezo cha mthupi kumapitirira, odwala angafunike mankhwala ochepa, osayang'anitsitsa, ndi kukhala ndi thanzi labwino lokhalitsa. Izi zinati, kufufuza kuyenera kuyambitsa mankhwala ogwiritsidwa ntchito omwe angathe kuletsa kukanidwa kuti asachitike kapena akhoza kuletsa patsogolo kukanidwa atapezeka.
> Zotsatira:
> Akatswiri amaganiza kuti apeza chifukwa cha kukanidwa kwa thupi m'thupi la odwala. NPR. http://sa.fm/post/researchers-think-theyve-found-cause-organ-rejection-transplant-patients#stream/0
> Donor SIRPA polymorphism imachititsa kuti thupi lanu lisamayende bwino. Science Immunology. http://immunology.sciencemag.org/content/2/12/eaam6202