Hiki ke hōʻole ʻia ka puʻuwai ma hope o ke kāpili ʻana? (Hōʻole ʻia ka Puʻuwai) E kamaʻilio kākou e pili ana i kēia!

ʻIke ʻoe, ʻo ka loaʻa ʻana o kahi puʻuwai hou ua like ia me ka hoʻomaka ʻana i kahi ola hou. He mea hōʻoluʻolu nui kēia, ʻoiai no kekahi mea i nāwaliwali loa kāna hana puʻuwai, ʻo ia hoʻi, ka hāʻule ʻana o ka puʻuwai hope loa . Eia naʻe, i kekahi manawa ʻike ko mākou kino i kēia puʻuwai hou he "malihini" a hoʻomaka e kūʻē iā ia. ʻO ia ka mea a mākou e kapa nei he Hōʻole Hoʻololi Puʻuwai . ʻOiai he mea weliweli iki kēia, ʻo ka hoʻomaopopo pono ʻana e pili ana i kēia hiki ke hōʻemi i nā pilikia he nui. No laila e kamaʻilio kākou e pili ana i kēia i kēia lā, ʻeā?

He aha maoli ka Hōʻole ʻana i ke Hoʻoili Puʻuwai?

I ka ʻōlelo maʻalahi, ʻo ka hoʻoili puʻuwai he hana ʻoki kino ia e wehe ʻia ai kahi puʻuwai i loko o ke kūlana koʻikoʻi a hoʻoili ʻia kahi puʻuwai olakino mai kahi mea hāʻawi i make. No laila, ke ʻike ka ʻōnaehana pale o kou kino i ka puʻuwai hou "ʻaʻole na ʻoe, akā na kekahi," hoʻomaka ia e hoʻouka i ka puʻuwai hou me he mea lā e hakakā ana i kahi maʻi. ʻO ia ke ʻano o ka hōʻole ʻana .

ʻO ka mea paha e hana ʻia kēia i loko o nā pule mua ma hope o ke kanu ʻana. Eia nō naʻe, i kekahi manawa hiki ke hana ʻia kēia ʻano ma hope o nā mahina a i ʻole nā ​​​​makahiki.

ʻO ka mea nui loa, ma mua o ke kāpili ʻana o ka puʻuwai, e hoʻomaka nā kauka iā ʻoe i nā lāʻau immunosuppressant . Hoʻāʻo kēia mau lāʻau e kāohi i ka ʻōnaehana pale o kou kino a pale iā ia mai ka hoʻouka ʻana i ka puʻuwai hou. Eia nō naʻe, i kekahi manawa me kēia mau lāʻau lapaʻau, ʻaʻole hiki ke hoʻōki loa ʻia ka hōʻole ʻana.

Hiki i ka hōʻole ʻana ke alakaʻi i kekahi mau pilikia. Eia kekahi laʻana:

• Nā ʻano ʻole o ka puʻuwai (Arrhythmia): Hiki i kēia ke alakaʻi i ka make koke.
• Ka hana ʻole ʻana o ka puʻuwai hou.
• Loaʻa i ka hāʻule puʻuwai.

He aha nā ʻano nui o ka hōʻole ʻia?

ʻEkolu mau ʻano nui o ka hōʻole ʻia i ʻike ʻia i nā hoʻoili puʻuwai:

1. Hōʻole ʻia ke kelepona koke: Hana ʻia kēia i ka wā e hoʻouka ai kahi ʻano kelepona kūikawā i loko o kāu ʻōnaehana pale i kapa ʻia ʻo nā kelepona T i nā kelepona puʻuwai hou. ʻO ka mea maʻamau kēia i nā mahina ʻekolu a ʻeono mua ma hope o ke kāpili ʻana.

2. Ka hōʻole mau ʻana: Hoʻokumu ʻia kēia e ka ʻōnaehana pale e hoʻomau nei i ka hoʻouka ʻana i ka graft i ka hala ʻana o ka manawa. I ka hapanui o nā hihia, ʻo nā kīʻaha koko nui e hoʻolako ana i ke koko i ka puʻuwai, ʻo ia hoʻi nā aʻa coronary, e mānoanoa mālie ana. Hoʻemi kēia i ka nui o ka oxygen a me nā meaʻai e pono ai ka puʻuwai.

3. Hōʻole humoral: Ua kapa ʻia kēia he hōʻole antibody koke.Ua kapa ʻia hoʻi. Hiki ke hana ʻia kēia i kēlā me kēia manawa ma hope o ke kāpili ʻana. ʻO ka mea e hana ʻia ma ʻaneʻi, ʻo nā antibodies i hana ʻia e kāu ʻōnaehana pale e hōʻino i nā kīʻaha koko i loko o ka puʻuwai hou. A laila ʻaʻole lawa ke kahe koko o ka puʻuwai.

Pehea ka maʻamau o kēia hōʻole ʻia ʻana e ka naʻau?

ʻO ka ʻoiaʻiʻo, ʻo kēia hōʻole ʻana he mea ia e ʻike ʻia i kekahi ʻano i waena o ka poʻe i loaʻa i kahi hoʻoili puʻuwai. Hiki ke hana ʻia kēia i kekahi manawa inā lawe pololei lākou i nā lāʻau immunosuppressant . Eia nō naʻe, ʻo ka nūhou maikaʻi, me ka holomua o ka ʻepekema lapaʻau, ʻoiai me ka ʻike ʻana i nā mea hou e pili ana i ka immunosuppression , ke emi mālie nei ka pilikia o kēia hōʻole ʻana.

He aha nā mea e hoʻonui ai i ka pilikia o ka hōʻole ʻia ʻana o ka naʻau?

Aia kekahi mau mea e hiki ke hoʻonui i ka pilikia o ka hōʻole ʻia. E nānā kākou i ke ʻano o lākou:

• ʻO kekahi mau kūlana olakino i loaʻa i ka mea loaʻa ka puʻuwai: No ka laʻana , ke kiʻekiʻe o ka cholesterol , ke kū'ē ʻana o ka insulin , a me ke koko kiʻekiʻe o ka pulmonary .
• ʻAʻole kūlike ka genetics ma waena o ka mea hāʻawi a me ka mea loaʻa.
• Inā he maʻi puʻuwai ko ka mea nāna i hāʻawi i ka puʻuwai.
• Inā loaʻa kekahi mea i ka puʻuwai i kona wā e wehe ʻia ana mai ke kino, e hoʻihoʻi ʻia mai, a hoʻokomo ʻia i loko o ke kanaka hou.
• ʻEleʻele ka mea e loaʻa ana ka puʻuwai (he mea kēia i loaʻa i nā haʻawina, ʻaʻole maʻamau i nā kānaka a pau).
• Inā ʻoi aku ka ʻōpiopio o ka mea e loaʻa ana ka puʻuwai ma mua o ka mea e hāʻawi ana i ka puʻuwai.
• ʻAʻole lawe ʻia nā lāʻau lapaʻau immunosuppressive i ka nui kūpono, i ka manawa kūpono, a i ʻole ʻaʻole hana pono me kekahi lāʻau lapaʻau hou.

He aha ke kumu e hōʻole ai nā naʻau?

Hana ʻia kēia no ka mea ua ʻike ka ʻōnaehana pale o kou kino i ka puʻuwai hou he "mea ʻē." A laila hoʻouna ia i nā pūnaewele T, a i ʻole nā ​​​​​​antibodies , e hoʻouka i ka "mea hoʻouka kaua."

Hiki ke hana ʻia kēia me ka nānā ʻole i nā lāʻau lapaʻau antirejection i hāʻawi ʻia i nā poʻe maʻi hoʻoili puʻuwai. ʻAʻole maopopo loa i nā kānaka ʻepekema ke kumu o kēia hana.

He aha nā hōʻailona o ka hōʻole ʻia ʻana o ka puʻuwai?

ʻO kēia ka ʻāpana huikau loa. I kekahi manawa hiki ke loaʻa ka hāʻule ʻana o ka puʻuwai me ka ʻole o nā hōʻailona! ʻO ia ke kumu e hoʻāʻo mau ai nā kauka iā ʻoe, e ʻike inā he hewa kekahi mea. Eia nō naʻe, loaʻa i kekahi poʻe nā hōʻailona.

ʻO nā hōʻailona maʻamau o ke kuni:

• ʻEha ʻōpū.
• ʻEha kino.
• Nā anu.
• Luhi loa (Fatigue).
• Ke kuni haʻahaʻa, me he mea lā ua wela loa ke kino.
• Ka luaʻi a i ʻole ka nalowale o ka makemake.
• Manaʻo maikaʻi ʻole.

Hiki paha ke loaʻa nā hōʻailona ʻē aʻe:

• Ka poniuniu a i ʻole ka māʻule ʻana.
• Nā palpitations o ka puʻuwai , ka puʻuwai wikiwiki a i ʻole ka puʻuwai kūpono ʻole.
• Ka emi ʻana o ka mimi ma mua o ka maʻamau (Oliguria) .
• Ke koko haʻahaʻa (Hypotension) .
• Ka paʻakikī o ka hanu ʻana (Dyspnea) .
• Piʻi koke ke kaumaha i manaʻo ʻole ʻia.
• Ka pehu ʻana o nā kuʻekuʻe wāwae, nā lima, a i ʻole nā ​​​​wāwae.

Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​​​pono ʻoe e hoʻomaopopo koke i kāu kauka, me ka kali ʻole i kāu manawa hou.

Pehea ʻoe e ʻike ai i ka hōʻole ʻia ʻana o ka naʻau?

Ma hope o kāu hoʻoili puʻuwai, e loaʻa iā ʻoe nā hoʻokolohua maʻamau e nānā no ka hōʻole ʻia. Hiki i kāu mau kauka ke kauoha i nā hoʻokolohua e like me:

• Nā hoʻāʻo koko e nānā i nā māka DNA e pili ana me ka hōʻole ʻana.
• ʻO kahi echocardiogram (e like me ke scan ultrasound o ka puʻuwai).
• Hoʻāʻo Electrocardiogram (ECG a i ʻole EKG) (e nānā ana i ka hana uila o ka puʻuwai).
• Hoʻāʻo koʻikoʻi o ka puʻuwai nuklea .
• ʻO Angiography ( kahi X-ray e nānā ana i nā kīʻaha koko o ka puʻuwai).
• ʻO ka ultrasound intravascular .
• ʻO ka biopsy myocardial a i ʻole ka biopsy puʻuwai: Pili kēia i ka lawe ʻana i kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai ka puʻuwai a nānā iā ia ma lalo o kahi microscope no nā hōʻailona o ka hōʻole ʻia. ʻO kēia ke ala maikaʻi loa e hōʻoia ai i ka hōʻole ʻia.

He aha ka mea e hana ai inā hōʻole ʻia ka puʻuwai?

ʻO ke ʻano o ka mālama ʻana e pili ana i nā kumu he nui, no ka laʻana:

• ʻAno hōʻole.
• Ke koʻikoʻi o ka hōʻole ʻia.
• Kou mau hōʻailona.
• Nā pilikia olakino ʻē aʻe āu e loaʻa nei.
• He aha nā lāʻau lapaʻau āu e lawe nei i kēia manawa?

Inā loaʻa iā ʻoe ka hōʻole ʻia o ka puʻuwai, hiki i nā kauka ke hana i nā mea e like me:

• Ke hoʻololi nei i nā ʻano lāʻau lapaʻau immunosuppressant āu e lawe nei, hoʻohui i nā mea hou, a i ʻole e hoʻonui ana i ka dosage.
• ʻO kahi lāʻau i kapa ʻia ʻo plasmapheresis a i ʻole photopheresis, ʻo ia ke ʻano o ka hoʻomaʻemaʻe ʻana i kou koko.
• ʻO ke ʻoki kino a i ʻole nā ​​​​kaʻina hana ʻē aʻe e hoʻomaikaʻi i ke kahe koko, e like me ka angioplasty a i ʻole ke ʻoki puʻuwai hāmama.
• Ke kuhikuhi ʻana i nā lāʻau lapaʻau mai ka hui corticosteroid , no ka laʻana , ʻo Prednisone .
• ʻO ka lawe ʻana i ka puʻuwai mai kahi mea hāʻawi hou a hana i kahi retransplant (he mea kākaʻikahi loa kēia).
• Ke hoʻohana nei i nā mīkini e kākoʻo i kou puʻuwai. Eia kekahi laʻana:ʻO ka Extracorporeal Membrane Oxygenator (ECMO) a i ʻole ka Ventricular Assist Device (VAD) .

He aha kaʻu e hana ai e pale aku ai i ka hōʻole ʻia ʻana o ka naʻau?

Aia kekahi mau mea hiki iā ʻoe ke hana e kōkua i ka hōʻemi ʻana i ka pilikia o ka hōʻole ʻia:

• E hōʻoia e hele i nā manawa a pau a kāu kauka. He mea nui loa kēia.
• E nānā pinepine i kou kaumaha, ke koko, a me ka mahana o ke kino. E haʻi i kāu kauka inā ʻike ʻoe i kekahi mau loli.
• E hahai i kahi nohona olakino. ʻO ia hoʻi ka ʻai ʻana i nā meaʻai momona, ka hoʻoikaika kino mau, a me ka haʻalele ʻana i ka puhipaka inā puhipaka ʻoe.
• Inā loaʻa iā ʻoe kekahi mau hōʻailona ʻē, e hoʻomaopopo koke i kāu kauka, me ka kali ʻole i kāu manawa e hiki mai ana.
• E lawe i nā lāʻau lapaʻau a pau i kuhikuhi ʻia e kāu kauka e like me ke kauoha, i ka manawa kūpono, a ma ke ana kūpono. Mai poina i hoʻokahi ana.
• Ma mua o ka lawe ʻana i kekahi lāʻau lapaʻau hou (ʻoiai he huaora), e nīnau i kāu kauka a kauka lāʻau paha inā e hoʻopilikia ia i kāu lāʻau anti-rejection.

He aha kaʻu e manaʻo ai inā e hōʻole ʻia au?

Ua emi iho ka pilikia o ka hōʻole ʻia ʻana o ka puʻuwai i ka hala ʻana o ka manawa. Eia nō naʻe, he mea nui e hoʻomanaʻo e hiki nō kēia ke hana i nā makahiki ma hope o ke ʻoki ʻana.

Inā hōʻole ʻia ʻoe, e kamaʻilio kāu kauka me ʻoe e pili ana i kāu mau koho. Hoʻokele ka hapa nui o ka poʻe i kēia kūlana me ka hoʻonui ʻia ʻana o nā lāʻau immunosuppressants a me nā lāʻau lapaʻau ʻē aʻe. ʻO 2% a 4% wale nō o ka poʻe i loaʻa i kahi hoʻoili puʻuwai e pono hou i kahi hoʻoili.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka e pili ana i ka hōʻole ʻia ʻana o ka puʻuwai?

Hiki iā ʻoe ke nīnau i kāu kauka i nā nīnau penei:

Ma mua o ke ʻoki kino:

• He kūpono anei ka puʻuwai o kēia mea hāʻawi noʻu?
• He aha kaʻu e hana ai e hōʻemi i ka pilikia o ka hōʻole ʻia ʻana o ka puʻuwai?
• He aha nā lāʻau antirejection e pono iaʻu e lawe?
• He aha nā hopena ʻaoʻao o kēlā mau lāʻau lapaʻau?
• ʻEhia pinepine e pono ai iaʻu ke nānā i koʻu kaumaha, ke koko, a me ka mahana o ke kino? He aha nā loli e pono iaʻu e hōʻike aku iā ʻoe?

Inā hōʻole ʻia:

• He aha ke ʻano o ka hōʻole ʻia iaʻu?
• He aha nā ʻano lāʻau lapaʻau e hiki ke kōkua iaʻu?
• Ua kūpono anei au no kahi hoʻoili puʻuwai ʻē aʻe?

ʻO ka mea hope loa, e hoʻomanaʻo i kēia.

He mea maʻamau ka hōʻole ʻia ma hope o kahi hoʻoili puʻuwai. Hiki ke hana ʻia i kēlā me kēia wahi mai kekahi mau lā a i ʻole mau makahiki ma hope o ke ʻoki ʻana. No laila, he mea nui e noho pili loa me kāu hui lapaʻau a hahai pono i kā lākou mau ʻōlelo aʻoaʻo.E kamaʻilio ākea me kāu kauka e pili ana i nā ala e hōʻemi ai i kou pilikia o ka hōʻole ʻia a me nā koho lapaʻau. Mai hopohopo, aia i kēia manawa he nui nā ala holomua e hoʻokele ai i kēia mau kūlana. E hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi.

Hoʻoili puʻuwai , hoʻoili puʻuwai, hōʻole puʻuwai, nā lāʻau pale ʻōnaehana pale, maʻi puʻuwai, hoʻoili kino, hōʻole hoʻoili puʻuwai