Ukutshintshwa kwePancreas

Umxholo

• Ngaba lukhona ngaphezulu kolunye udidi lokufakelwa kwepancreas?
• Ngubani onikela ngepancreas?
• Kuya kuthatha ixesha elingakanani ukufumana ipancreas?
• Kwenzeka ntoni ngaphambi kokufakwa kwepancreas?
• Kwenziwa njani ukufakelwa kwepancreas?
• Kwenzeka ntoni emva kokuba kwenziwe ukufakelwa kwepancreas?
• Ngaba bukhona ubungozi obunxulunyaniswa nokufakelwa kwepancreas?
• Yintoni eyokuthathwa komntu oqwalaselwa ukufakelwa kwepancreas?

Yintoni ukufakelwa kwepancreas?

Nangona ihlala isenziwa njengendawo yokugqibela, ukufakelwa kwepancreas kuye kwaba lonyango oluphambili kubantu abanesifo seswekile sokuqala. Ukutshintshwa kwepancreas ngamanye amaxesha kwenziwa kubantu abafuna unyango lwe-insulin kwaye banesifo seswekile sesi-2. Nangona kunjalo, oku kuxhaphake kakhulu.

Ukufakelwa kwepancreas kokuqala kwabantu kwagqitywa ngo-1966. I-United Network for Organ Sharing (UNOS) inika ingxelo yokuba ngaphezulu kwama-32,000 otyando lwenziwe e-United States phakathi kukaJanuwari 1988 no-Epreli 2018.

Injongo yokufakelwa kwakhona kukubuyisela amanqanaba eswekile yegazi emzimbeni. Ipancreas efakelweyo iyakwazi ukuvelisa i-insulin ukulawula amanqanaba eglucose egazini. Lo ngumsebenzi ongenza ukuba iipancreas ezikhoyo zomviwa zingakwazi ukwenza ngokufanelekileyo.

Ukufakelwa kwepancreas kwenziwa ikakhulu kubantu abanesifo seswekile. Ngokwesiqhelo ayizukusetyenziselwa ukuphatha abantu abanezinye iimeko. Kunqabile ukuba kwenziwe ukunyanga umhlaza othile.

Ngaba lukhona ngaphezulu kolunye udidi lokufakelwa kwepancreas?

Kukho iintlobo ezininzi zokufakelwa kwepancreas. Abanye abantu banokuba ne-pancreas transplant yedwa (i-PTA). Abantu abane-nephropathy yeswekile-ukonakala kwezintso kwisifo seswekile-banokufumana i-pancreas yomnikeli kunye nezintso. Le nkqubo ibizwa ngokuba kukufakelwa ngepancreas-kidney ngaxeshanye.

Iinkqubo ezifanayo zibandakanya iipancreas emva kwezintso (PAK) kunye nezintso emva kokudityaniswa kwepancreas (KAP).

Ngubani onikela ngepancreas?

Umnikeli wepancreas uhlala engumntu oxeliweyo ukuba ufile-ngengqondo kodwa uhlala kumatshini wokuxhasa ubomi. Lo mnikeli kufuneka ahlangabezane neenqobo eziqhelekileyo zokufakelwa, kubandakanya ukuba neminyaka ethile kwaye usempilweni.

Iipancreas zomnikeli nazo kufuneka zitshatise umzimba wokuzikhusela kunye nomzimba womamkeli. Oku kubalulekile ukunceda ukunciphisa umngcipheko wokwaliwa. Ukwalelwa kwenzeka xa amajoni omzimba omamkeli esabela ngokungalunganga kwilungu elinikelwayo.

Ngamaxesha athile, abanikeli bepancreatic bayaphila. Oku kunokwenzeka, umzekelo, ukuba ummkeli wofakelo unokufumana umnikeli osisihlobo esisondeleyo, njengewele elifanayo. Umnikeli ophilayo unika inxenye yepancreas, hayi ilungu elipheleleyo.

Kuya kuthatha ixesha elingakanani ukufumana ipancreas?

Kukho abantu abangaphezu kwama-2 500 kuluhlu lokulinda lolunye uhlobo lwepancreas transplant eMelika, iphawula iUNOS.

Ngokuka-Johns Hopkins Medicine, umntu ophakathi uzakulinda unyaka omnye ukuya kwemibini ngaphambi kokuba enze i-SPK. Abantu abafumana ezinye iintlobo zokufakelwa, njenge-PTA okanye iPAK, baya kuchitha ngaphezulu kweminyaka emibini kuluhlu lokulinda.

Kwenzeka ntoni ngaphambi kokufakwa kwepancreas?

Uya kufumana uvavanyo lwezonyango kwiziko lokufakelwa ngaphambi kokuba naluphi na uhlobo lokufakelwa komzimba. Oku kuya kubandakanya iimvavanyo ezininzi ukumisela impilo yakho iyonke, kubandakanya novavanyo lomzimba. Ingcali yokhathalelo lwempilo kwiziko lokufakelwa izakujonga kwakhona imbali yakho yezonyango.

Ngaphambi kokuba ufumane ukufakelwa kwepancreas, uvavanyo oluthile onokulufumana lubandakanya:

• iimvavanyo zegazi, njengokuchwetheza igazi okanye uvavanyo lwe-HIV
• iX-reyi yesifuba
• Uvavanyo lwezintso
• iimviwo ze-neuropsychological
• izifundo zokujonga ukusebenza kwentliziyo yakho, njenge-echocardiogram okanye i-electrocardiogram (EKG)

Le nkqubo yovavanyo iya kuthatha inyanga enye ukuya kwezimbini. Injongo kukuqinisekisa ukuba ngaba ungumgqatswa ofanelekileyo woqhaqho kwaye uya kuba nakho ukuphatha irejimeni yonyango emva kotyando.

Ukuba kugqityiwe ukuba ukufakelwa kuya kukulungela, uya kubekwa kuluhlu lokulinda lweziko lokufakelwa.

Gcina ukhumbula amaziko okufakelwa ngokwahlukeneyo aya kuba neenkqubo ezahlukeneyo zangaphambi kokusebenza. Oku kuya kwahluka ngakumbi ngokuxhomekeka kuhlobo lomnikeli kunye nempilo iyonke yomamkeli.

Kwenziwa njani ukufakelwa kwepancreas?

Ukuba umnikeli akasekho, ugqirha wakho uyakususa i-pancreas kunye necandelo eliqhotyoshelweyo lamathumbu abo amancinci. Ukuba umnikeli uyaphila, ugqirha wakho oqhelekileyo uya kuthatha inxenye yomzimba kunye nomsila wepancreas.

Inkqubo ye-PTA ithatha iiyure ezimbini ukuya kwezine. Le nkqubo yenziwa phantsi kwe-anesthesia ngokubanzi, ke ngoko ukufakelwa komamkeli akazi nto kwaphela ukuze angaziva buhlungu.

Ugqirha wakho usika kumbindi wesisu sakho kwaye ubeke izicubu zomnikeli kwisisu sakho esisezantsi. Baza kuthi ke emva koko banamathisele icandelo elitsha lomnikezeli wamathumbu amancinci aqukethe i-pancreas (ukusuka kumnikeli ongasekhoyo) kumathumbu akho amancinci okanye kwi-pancreas yomnikeli (ukusuka kumnikeli ophilayo) kwisinyi sakho somchamo kwaye unamathisele ipancreas kwimithambo yegazi. Iipancreas ezikhoyo zomamkeli zihlala zihlala emzimbeni.

Utyando luthatha ixesha elide ukuba izintso ziphinde zafakwa ngenkqubo ye-SPK. Ugqirha wakho uza kuncamathisela i-ureter yezintso zomnikeli kwisinyi nakwimithambo yegazi. Ukuba kunokwenzeka, baya kushiya izintso esele zikhona.

Kwenzeka ntoni emva kokuba kwenziwe ukufakelwa kwepancreas?

Emva kokufakelwa, abafumanayo bahlala kwigumbi lokunyamekela (ICU) kwiintsuku zokuqala ukuvumela ukubeka iliso ngokusondeleyo kuzo naziphi na iingxaki. Emva koku, bahlala beya kwiyunithi yokubuyisela ngaphakathi esibhedlele ukuze baphinde bachache.

Ukufakelwa kwepancreas kubandakanya iintlobo ezininzi zamayeza. Unyango lweziyobisi zomamkeli luya kufuna ukubekwa esweni ngokubanzi, ngakumbi kuba baya kuthatha inani lala machiza mihla le ukuthintela ukwaliwa.

Ngaba bukhona ubungozi obunxulunyaniswa nokufakelwa kwepancreas?

Njengalo naluphi na utshintsho lomzimba, ukufakelwa kwepancreas kuthwala ukubakho kokwaliwa. Ikwanomngcipheko wokusilela kwepancreas uqobo. Umngcipheko kule nkqubo usezantsi, ngenxa yenkqubela phambili kunyango kunye nonyango lwe-immunosuppressant. Kukwakho nengozi yokufa enxulumene naluphi na utyando.

Ikliniki yaseMayo iqaphela ukuba iminyaka emihlanu yokusinda kwepancreases ukufakelwa malunga neepesenti ezingama-91. Ngokuka-a, isiqingatha sobomi (ihlala ixesha elingakanani) yokufakelwa kwepancreas ekufakweni kwe-SPK ubuncinci iminyaka eli-14. Abaphandi baqaphela ukuba ukusinda ixesha elide komamkeli kunye nepancreas kulomelo lokufakelwa kunokufezekiswa ngabantu abanesifo seswekile sesi-2 kwaye sele bekhulile.

Oogqirha kufuneka balinganise izibonelelo zexesha elide kunye nomngcipheko wokufakelwa ngokuchasene neengxaki kunye nokubakho kokufa okunxulumene nesifo seswekile.

Inkqubo ngokwayo inemingcipheko emininzi, kubandakanya ukopha, amahlwili egazi, kunye nosulelo. Kukho umngcipheko owongeziweyo we-hyperglycemia (iswekile ephezulu yegazi) eyenzeka ngexesha nangasekunene emva kokufakelwa.

Amachiza anikwe emva kokufakelwa anokubangela iziphumo ebezingalindelekanga ezibi. Abamkeli bokufakwa kufuneka bathathe uninzi lwezi ziyobisi ixesha elide ukunqanda ukwaliwa. Iziphumo zala machiza zibandakanya:

• cholesterol ephezulu
• igazi elonyukayo
• hyperglycemia
• ukunciphisa amathambo (i-osteoporosis)
• ukulahleka kweenwele okanye ukukhula kakhulu kweenwele emadodeni okanye kubafazi
• ukutyeba kwakho

Yintoni eyokuthathwa komntu oqwalaselwa ukufakelwa kwepancreas?

Ukusukela ukufakelwa kwepancreas okokuqala, kuye kwakho inkqubela phambili eninzi kwinkqubo. Ezi nkqubela phambili zibandakanya ukukhetha okungcono kwabaxhasi bamalungu kunye nokuphuculwa kwonyango lwe-immunosuppressant ukuthintela ukwaliwa kwezicubu.

Ukuba ugqirha wakho ugqiba ukuba ukufakelwa kwepancreas lukhetho olufanelekileyo kuwe, inkqubo iya kuba nzima. Kodwa xa ukufakelwa kwepancreas kuphumelele, abafumanayo baya kubona ukuphucuka komgangatho wabo wobomi.

Thetha nogqirha wakho ukuba ubone ukuba ukufakelwa kwepancreas kukulungele na.

Abantu abajonga ukufakelwa komzimba banokucela ikiti yolwazi kunye nezinye izinto zasimahla ezivela kwi-UNOS.