E aʻo kākou i nā mea āpau e pili ana i ka Stem Cell Transplant ma ke ala maʻalahi.

Ua lohe paha ʻoe i nā hoʻoili ʻana o nā cell stem. He lāʻau lapaʻau pono loa ia no kekahi mau maʻi. Akā, he manawa iki ko lākou e ho'ōla piha ai. E kamaʻilio hou anei kākou e pili ana i kēia me nā kikoʻī hou aku, e like me kā kākou kamaʻilio ʻana me kahi hoaaloha?

He aha nā Kelepona Kumu?

I ka ʻōlelo maʻalahi, he ʻano cell kūikawā loa nā cell kumu i loko o ko mākou kino. Loaʻa i kēia mau cell ka hiki kupaianaha ke ulu i nā ʻano cell like ʻole. ʻO nā cell kumu a mākou e kamaʻilio nei ma kēia hoʻoili cell kumu ʻo ia nā mea e hoʻoulu ai i nā cell koʻikoʻi i loko o ko mākou koko. ʻO ia hoʻi:

• Nā hunaola koko ʻulaʻula: ʻO kēia nā mea e lawe ai i ka oxygen ma ke kino holoʻokoʻa.
• Nā hunaola koko keʻokeʻo: Mālama kēia mau hunaola iā mākou ma ke kaua ʻana i nā huakini a me nā maʻi e komo i loko o ko mākou kino.
• Nā Platelets: ʻO kēia nā mea e kōkua ai i ke kāpili ʻana o ke koko ke loaʻa kahi ʻeha.

E noʻonoʻo e like me kēia mau pūnaewele kumu e like me kahi puʻu lepo e hiki ke hana ʻia i kekahi mea. Ma muli o ka pono, hiki ke hoʻohana ʻia e hana i nā hunaola koko ʻulaʻula, nā hunaola koko keʻokeʻo, a i ʻole nā ​​platelets.

No ke aha e hana ʻia ai kēia mau hoʻoili pūnaewele kumu?

I kēia manawa, e nānā kākou i nā hihia hea e hiki ai i kēia mau hoʻoili cell kumu ke kōkua. ʻAʻole kēia he mea i hana ʻia no kēlā me kēia maʻi, akā i kekahi mau hihia koʻikoʻi, ʻo ia ka hopena maikaʻi loa.

• No nā poʻe me nā maʻi koʻikoʻi e pili ana i ke koko: No ka laʻana, kekahi mau ʻano leukemia, e kū mai ana i ka wā e hana pono ʻole ai ka iwi iwi.
• No nā poʻe me kekahi ʻano maʻi kanesa: Nā maʻi kanesa e like me ka lymphoma a i ʻole ka myeloma maha.
• No ka poʻe me ka hemahema nui o ke kino: Ua nāwaliwali loa ko lākou ʻōnaehana pale ʻaʻole hiki i ko lākou kino ke pale aku i nā maʻi.
• No nā poʻe me kekahi mau maʻi autoimmune: No ka laʻana, i nā maʻi e like me lupus, i ka wā e hoʻouka ai nā pūnaewele ponoʻī o ke kino i ke kino.
• He kūpono loa hoʻi kēia lāʻau lapaʻau no nā maʻi koko hoʻoilina ʻē aʻe: Thalassemia a i ʻole Sickle Cell Disease.

Ma hea mākou e loaʻa ai kēia mau hunaola kumu?

ʻAe, i kēia manawa ke noʻonoʻo nei paha ʻoe i kahi e loaʻa ai iā mākou kēia mau cell kumu makamae. ʻEkolu mau wahi nui e hiki ai i nā kauka ke loaʻa i kēia mau cell:

1. ʻO ka iwi iwi: ʻO kēia ke ʻano hana kaulana loa. Ua kapa pinepine ʻia kēia he 'Bone Marrow Transplant'. ʻO ka iwi iwi ka ʻāpana palupalu a huʻahuʻa i loko o ko kākou mau iwi nui. ʻO ia kahi e hana ʻia ai nā hunaola koko.

2. Ma o ke Kahe Koko: Ma ka hāʻawi ʻana i nā lāʻau lapaʻau kūikawā, hiki ke hoʻokuʻu ʻia nā pūnaewele kumu mai ka iwi iwi i loko o ke kahe koko, a laila hiki ke hōʻiliʻili ʻia kēia mau pūnaewele ma o kahi mīkini e like me ka hāʻawi koko maʻamau. Ua kapa ʻia kēia he hōʻiliʻili ʻo Peripheral Blood Stem Cell (PBSC).

3.Koko o ke kaula piko: Ma hope o ka hānau ʻana o kahi pēpē, ke wehe ʻia ke kaula piko, aia i loko o ke koko i waiho ʻia kēia mau hunaola kumu waiwai nui. Hiki ke hōʻiliʻili ʻia a hoʻohana ʻia e kekahi mea nele.

Ma kēia ʻano, kapa mākou i ka mea nāna e hāʻawi i nā cell kumu he 'mea hāʻawi' . ʻO ka mea nui loa, i kekahi mau maʻi, hiki i ke kanaka me ka maʻi ke lilo i mea hāʻawi ponoʻī nona. ʻO ia hoʻi, lawe ʻia kāna mau cell kumu ponoʻī ma mua o ka hoʻomaka ʻana o ka mālama ʻana i ka maʻi, hoʻopaʻahau ʻia, a laila hoʻoili hou ʻia iā ia i ka wā e pono ai. Ua kapa ʻia kēia ʻo 'Autologous Transplant' .

Akā i ka hapa nui o ka manawa, hāʻawi kekahi i kēia mau cell. Ua kapa ʻia kēia he 'Allogeneic Transplant' . Inā lawe ʻia nā cell kumu mai kekahi, pono e like loa ke ʻano genetic o kēlā mau cell, ʻoiai nā māka HLA (Human Leukocyte Antigen). I ka ʻōlelo maʻalahi, loaʻa i kēlā me kēia cell i loko o ko mākou kino kahi kāleka ID liʻiliʻi. Pono e like loa kēia mau kāleka ID ʻelua, inā ʻaʻole e ʻae ke kino i nā cell hou. ʻO ka maʻamau, ʻo ke kaikaina o ke keiki ka mea kūpono loa. I kekahi manawa, hiki ke loaʻa kahi kūpono mai kahi makua a i ʻole kahi mea hāʻawi pili ʻole. Aia nā waihona ʻikepili nui (nā papa inoa) no kēia e ʻimi i nā mea hāʻawi kūpono.

He aha ka mea e hana ai inā ʻaʻole loaʻa kahi mea hāʻawi kūpono?

E noʻonoʻo, inā ʻaʻole kūlike nā cell kumu mai ka mea hāʻawi (i kekahi manawa inā he kūlike kūpono lākou, hiki i kēia mau pilikia ke kū i kahi nui a liʻiliʻi paha), hiki ke kū mai nā pilikia nui ʻelua:

1. Hōʻole ʻia: ʻO kēia ka manawa e hoʻouka ai ka ʻōnaehana pale o ka mea maʻi i nā pūnaewele hāʻawi i hoʻoili hou ʻia. Manaʻo ia, "ʻAʻole kēia nā pūnaewele ponoʻī o kākou, ua like lākou me nā mea hoʻouka kaua haole," a hoʻāʻo e luku iā lākou. Pale ʻia kēia e nā lāʻau immunosuppressive.

2. Ka Maʻi Graft-versus-Host (GVHD): ʻO ke kū'ē kēia. Hoʻomaka nā pūnaewele pale o ka mea hāʻawi i hoʻoili hou ʻia (ʻo ia hoʻi nā T-lymphocytes) e hoʻouka i nā pūnaewele olakino i loko o ke kino o ka mea maʻi, me ka manaʻo, "ʻAʻole na mākou kēia kino." Hiki i kēia ke hoʻopilikia i nā wahi e like me ka ʻili, ke akepaʻa, a me nā ʻōpū. Aia nā lāʻau lapaʻau e kāohi i kēia.

Pehea e hana ʻia ai kēia kaʻina hana hoʻoili pūnaewele kumu?

ʻAe, e nānā kākou pehea e hana ai kēia kaʻina hana hoʻoili. He kaʻina hana ia he nui nā ʻanuʻu.

1. Hoʻomākaukau:

Ma mua o ka hoʻoili ʻana o nā cell stem, e hoʻokomo nā kauka i kahi mea i kapa ʻia ʻo 'central line', a i ʻole 'central venous catheter' . Ua like kēia me kahi laina IV (intravenous) nui a kūikawā. Hoʻokomo ʻia i loko o kahi aa nui kokoke i ka puʻuwai, ma lalo o ka ʻili ma ka ʻāʻī, ka umauma, a i ʻole ka ʻūhā. Hiki ke waiho ʻia kēia laina waena no kahi manawa lōʻihi ma mua o ka IV maʻamau. ʻOi aku ka maʻalahi o kēia no nā kauka a me nā kahu maʻi e hāʻawi iā ʻoe i ka lāʻau lapaʻau, lawe i nā hāpana koko, a hāʻawi iā ʻoe i nā cell i hoʻoili ʻia. ʻAʻole pono ʻoe e loaʻa pinepine i nā nila.

2. Lapaʻau hoʻomaʻamaʻa:

Hana ʻia nā hoʻoili ʻana o nā cell stem ma kahi keʻena kūikawā ma ka haukapila. ʻO ka mea mua, hāʻawi ʻia ka mea e loaʻa ana i nā cell donor (ka mea loaʻa) i nā dosis kiʻekiʻe o ka chemotherapy a/a i ʻole radiation no kekahi mau lā. Ua kapa ʻia kēia he lāʻau hoʻomaʻamaʻa. Hana ʻia kēia no ʻelua mau kumu nui:

• E luku i nā ʻāpana ʻino a hōʻino (e like me nā ʻāpana maʻi ʻaʻai, nā ʻāpana iwi ʻiʻo e hana pono ʻole ana) e hoʻoulu ai i ka maʻi.
• E hoʻonāwaliwali i kāna ʻōnaehana pale i hiki ke hoʻokomo pono ʻia nā hunaola i hāʻawi hou ʻia me ka ʻole e hōʻole ʻia.

3. Hoʻoili ʻana i nā pūnaewele kumu:

Ma hope o ka pau ʻana o ka mālama ʻana, ma hope o hoʻokahi a ʻelua paha lā o ka hoʻomaha, hoʻokomo ʻia nā hunaola kumu mai ka mea hāʻawi i loko o ka mea maʻi ma o kahi laina waena (e like me ka hāʻawi ʻana i ke koko). He hana kēia e lawe ana i kekahi mau hola. Hele kēia mau hunaola ma o ke koko a noho i loko o ka iwi iwi, kahi e hoʻomaka ai lākou e hana i nā hunaola koko hou a olakino.

He aha ka mea e hana ʻia ma hope o ke kāpili ʻana?

Ma hope o ka loaʻa ʻana o kahi hoʻoili ʻana o nā cell kumu i ke kanaka, liʻuliʻu ka manawa no ko lākou kino e hana i nā hunaola koko ʻulaʻula hou, nā hunaola koko keʻokeʻo, a me nā platelets. ʻO ka maʻamau, ma kahi o 2-4 mau pule no kēia mau hunaola hou e hoʻomaka ai e hana. I loko o kēia manawa, kiʻekiʻe loa ka pilikia o nā maʻi, ke kahe ʻana o ke koko, a me nā pilikia ʻē aʻe. ʻO kēia no ka mea, haʻahaʻa loa ka helu o nā hunaola koko ʻoiai e luku ʻia ana nā hunaola koko kahiko a hana ʻia nā mea hou.

Noho ka hapa nui o ka poʻe i loko o kahi lumi kūikawā ma ka haukapila no 3 a 5 mau pule (a ʻoi aku paha) ma hope o kā lākou hoʻoili ʻana. I loko o kēia manawa, makaʻala loa ka hui lapaʻau e pili ana i kēia mau mea:

• Hana ʻia nā hoʻāʻo koko i kēlā me kēia lā e ʻike ai inā e hana ʻia ana nā hunaola koko hou mai nā hunaola kumu i hoʻoili ʻia.
• Hāʻawi ʻia ka lāʻau lapaʻau e pale aku i ka hōʻole ʻia ʻana a me ka Graft-versus-Host Disease (GVHD).
• Hoʻohana ʻia nā lāʻau lapaʻau e like me nā antibiotics, antifungals, a me nā antivirals e pale aku ai i nā maʻi.
• Inā pono, hāʻawi ʻia nā hunaola koko ʻulaʻula a me nā platelets ma waho (transfusions).
• Nānā ia inā e hana pono ana nā ʻōkana e like me ke akepaʻa a me nā puʻupaʻa.
• Hoʻōla koke ʻia nā pilikia e like me nā ʻeha waha, ka luaʻi ʻana, ka maʻi pākīkī, nā maʻi, ke kahe ʻana o ke koko, ka hōʻole ʻia ʻana, a i ʻole GVHD.
• E hōʻoia i ka loaʻa ʻana o ka meaʻai kūpono i ka mea maʻi. Hiki i kēia ke komo pū me ka hānai ʻana i ka paipu a i ʻole ka hānai parenteral holoʻokoʻa (TPN).
• Nānā ʻia nā mea a pau e hele mai ana i ka haukapila e hōʻoia i ko lākou hahai ʻana i nā lula pale ʻana i ka maʻi. ʻO ia hoʻi:
• ʻAʻole hiki i kekahi mea me kekahi maʻi (ʻoiai ke anu) ke hele mai e ʻike i ka mea maʻi.
• Pono nā kānaka a pau e holoi pono i ko lākou mau lima ma mua o ke komo ʻana i loko o ka lumi.
• Pono nā kānaka a pau e komo i ka mask, nā mikina lima, a me ka ʻaʻahu komo.

Pehea e hiki ai i nā mākua (inā he keiki) ke kōkua?

Ma hope o ka loaʻa ʻana o kahi hoʻoili cell kumu i ke keiki,He 6 a 12 mau mahina, a ʻoi aku paha, no ka hoʻōla piha ʻana o ka ʻōnaehana pale. A hiki i kēlā manawa, hiki i nā maʻi liʻiliʻi ke paʻakikī loa no nā keiki. Hiki i ke anu maʻamau ke lilo i mea weliweli. Eia kekahi mau mea hiki iā ʻoe ke hana e kōkua i ka pale ʻana i kāu keiki mai nā maʻi:

• Pono kāu keiki, nā ʻohana, a me nā malihini (nā mea i ʻae ʻia e kipa) e holoi pono i ko lākou mau lima me ke kopa antibacterial a/a i ʻole ka mea hoʻomaʻemaʻe lima. ʻO kēia ka mea nui loa.
• Mai lawe mai i kekahi mea maʻi a kokoke i ke keiki.
• E ʻauʻau i kāu keiki i kēlā me kēia lā me ka shampoo akahai a me ke kopa. E mālama i ka ʻili i maʻemaʻe.
• E hahai pono i nā ʻōlelo a ke kauka:
• Āhea e hiki ai i ke keiki ke hele i ke kula a i ʻole nā ​​wahi lehulehu ʻē aʻe (nā wahi piha kanaka, nā hale kiʻiʻoniʻoni, nā hale kūʻai kūʻai).
• I ka manawa hea e pono ai i ke keiki ke komo i ka pale maka i ka wā e hele ai i waho?
• He aha nā meaʻai maikaʻi i ke keiki e ʻai ai a he aha nā meaʻai maikaʻi ʻole i ke keiki e ʻai ai (e like me nā salakeke maka, ka ʻiʻo a me ka iʻa i moʻa pono ʻole ʻia).
• Hiki i ke keiki ke noho a puni nā holoholona a hoʻopā iā lākou?

He aha hou aʻe kā mākou e pono ai e ʻike?

Hoʻōla hou ka nui o nā keiki (a me nā mākua) ma hope o ka loaʻa ʻana o kahi hoʻoili cell stem. Eia nō naʻe, ʻo ka manawa i hoʻolilo ʻia ma ka haukapila a me ka manawa i hoʻolilo ʻia e hoʻōla ai ma ka home hiki ke lilo i mea paʻakikī no ka mea maʻi a me ko lākou ʻohana, ma ka noʻonoʻo a me ke kino.

"Mai ho'āʻo e hele hoʻokahi ma kēia huakaʻi. E noi i ke kōkua."

E kiʻi i ke kākoʻo mai nā ʻohana ʻē aʻe, nā hoaaloha, kāu hui lapaʻau, he kākāʻōlelo, a he limahana hana kaiaulu paha. Hiki iā ʻoe ke mālama pono i kāu mea maʻi (a i ʻole keiki, inā he keiki) inā mālama pono ʻoe iā ʻoe iho.

No ke kōkua ʻana i kāu mea maʻi e hoʻōla a noho olakino, e hana i kēia mau mea:

• E mālama i nā kipa a pau a ke kauka a hāʻawi i kāu lāʻau lapaʻau i ka manawa kūpono.
• Kākoʻo a paipai i ka mea maʻi i ka wā o nā loli kino (e like me ka hāʻule ʻana o ka lauoho, ka luhi, nā loli o ka ʻili) e hiki mai ana ma muli o ka chemotherapy a me/a i ʻole ka radiation.
• E kōkua iā lākou e hoʻoponopono i ka mehameha a me ke kaʻawale e hele mai me ka mamao aku mai nā hoaaloha a me ka ʻohana i ko lākou wā e hoʻōla ai. E hāʻawi i nā manawa kūpono e kamaʻilio ai, ʻoiai ma o nā kelepona wikiō.
• E nīnau i ka mea maʻi inā makemake lākou e kamaʻilio me kekahi kākā'ōlelo a mea hana kaiaulu paha e kōkua iā lākou e hoʻoponopono i nā manaʻo e like me ke kaumaha, ka makaʻu, a me ka huhū e kū mai ana i ka wā e hoʻōla ai.
• E kōkua i ka mea maʻi (ʻoi aku hoʻi ke keiki) e hoʻokumu i kahi hana maʻamau i kēlā me kēia lā e komo pū ana me ka hoʻoikaika kino māmā (inā ʻae ʻia e ke kauka), nā meaʻai i nā manawa maʻamau, a me nā hana a lākou e hauʻoli ai, e like me ka pāʻani, ka heluhelu ʻana, a me ke kaha kiʻi.

Āhea mākou e pono ai e ʻike koke i ke kauka?

Aia kekahi mau pilikia ke hoʻi ʻoe i ka home ma hope o kāu hoʻoili ʻana. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona:Pono ʻoe e kāhea koke i ke kauka , me ka hoʻokaʻulua ʻole i hoʻokahi minute, a i ʻole pono ʻoe e lawe ʻia i ka haukapila:

• Inā he 38.0°C (100.4°F) a ʻoi aku paha ka mahana ke nānā ʻia mai ka waha mai (ʻo kēia ka hōʻailona weliweli loa).
• Inā he ihu wai kou, he ʻū, he ʻūmiʻi ka umauma, a he paʻakikī paha ka hanu ʻana.
• Inā hoʻomau ka luaʻi a i ʻole ka maʻi pākī.
• Inā ʻoe e hele ana i loko o nā ʻōpala ʻeleʻele, he ʻōpala palai (he hōʻailona paha kēia o ke kahe ʻana o ke koko i loko o nā ʻōpū).
• Inā maʻalahi kou palapū a i ʻole he kahe koko hiki ʻole ke hoʻōki (e like me ka ihu a i ʻole nā ​​ʻāʻī).
• Inā he koko i loko o ka mimi, a inā paha ua loli ke kala o ka mimi.
• Inā he ʻeha poʻo nui kou, he poniuniu, a he hihiʻo pōwehiwehi paha.
• He mea maikaʻi ke kuʻi ʻana i ke koko, akā inā ʻaʻole hiki iā ʻoe ke kāohi i ke kahe ʻana o ka ihu i loko o kekahi mau minuke,
• Inā ʻike ʻia kekahi mea hou ma ke kino, e like me ka ʻulaʻula.

ʻO ka mea hope loa, kekahi mau mea nui e hoʻomanaʻo

No laila, hiki i ka hoʻoili ʻana o nā cell kumu ke lilo i lāʻau lapaʻau holomua loa, hoʻololi ola no kekahi mau maʻi koʻikoʻi. Akā he hana nui ia, a ʻo ka hoʻōla ʻana e pono ai ka manawa, ke ahonui, a me ka hoʻolaʻa. ʻO ka mea nui loa, ʻo ia ka hahai pololei i nā ʻōlelo a ke kauka, hāʻawi i ka mea maʻi (inā he keiki, ʻo ke keiki) ke aloha, ke aloha, a me ke kākoʻo kūpaʻa ʻole, a pale aku iā lākou mai nā maʻi.

E hoʻomanaʻo, ʻaʻole ʻoe a me kāu mea maʻi wale nō i kēia huakaʻi paʻakikī! Aia pū ka hui lapaʻau, ka ʻohana, a me nā hoaaloha me ʻoe. Inā he mau nīnau a kānalua paha kāu, ʻaʻohe mea liʻiliʻi, mai makaʻu e nīnau i ka hui lapaʻau. Aia lākou ma laila e kōkua iā ʻoe.

ʻO ka hoʻoili ʻana i nā pūnaewele kumu, ka hoʻoili ʻana i nā pūnaewele kumu, ka hoʻoili ʻana i nā iwi iwi, nā maʻi koko, ka maʻi ʻaʻai, ka palekana, ke olakino o nā keiki, ʻike lapaʻau Sinhala, ka hoʻoili ʻana i nā iwi iwi