Izinto Ezinomthelela Ezindlekweni Zokuhlinzwa Kokufakelwa Inhliziyo

Izici eziningi zithonya izindleko zokugcina zokuhlinzwa kokufakelwa kwenhliziyo, okudala ukuhluka okuphawulekayo kwezindleko ukusuka esimweni esisodwa kuya kwesinye. 

Isimo sempilo yesiguli sidlala indima ebalulekile ekunqumeni izindleko. Ucwaningo lubonisa ukuthi iziguli ezinezikolo eziphansi ze-INTERMACS (ezibonisa ukuhluleka kwenhliziyo okubi kakhulu) ngokuvamile zifaka izindleko zokwelashwa eziphakeme.

Kunezici ezimbalwa ezibalulekile ezithinta izindleko zizonke:

• Izimpawu Zesibhedlela
  • Ubuchwepheshe besikhungo
  • Indawo yesibhedlela
  • Ingqalasizinda yezokwelapha etholakalayo
  • Ikhwalithi yokunakekelwa kwangemva kokuhlinzwa
• Izici eziqondene nesiguli
  • Ubude bokuhlala esibhedlela
  • Izinkinga ngesikhathi sokwelashwa
  • Izimo zezokwelapha ezivele zikhona
  • Impendulo ekwelashweni

Kungani Kudingeka Ukuhlinzwa Kokufakelwa Kwenhliziyo?

Odokotela batusa ukuhlinzwa kokufakelwa inhliziyo lapho ukwelashwa okuvamile kwehluleka ukuphatha izimo ezinzima zenhliziyo. 

Ukuhlinzwa kubaluleke kakhulu ezigulini ezihlangabezana nazo:

• Ukuncipha okukhulu kwemisipha yenhliziyo (i-cardiomyopathy)
• Isifo se-coronary artery esithuthukisiwe
• Izinkinga ezinkulu ze-valve yenhliziyo
• Izinkinga zesigqi senhliziyo ezisongela ukuphila
• Kwehlulekile ukufakelwa inhliziyo okwedlule
• Ukukhubazeka kwenhliziyo okuzalwa

Isidingo sokufakelwa inhliziyo ngokuvamile sivela lapho iziguli zifika esigabeni IIIB kuya esigabeni IV sesifo senhliziyo, lapho izimpawu zivela khona phakathi nomsebenzi omncane noma ngisho nalapho ziphumule. Le nqubo inikeza amazinga okusinda athuthuke kakhulu ezigulini ezikhethwe ngokucophelela, nokusinda konyaka owodwa ngemuva kokuhlinzwa kufinyelela ku-85-90%.

Ubani Odinga Ukuhlinzwa Kokufakelwa Inhliziyo?

Iziguli ezifuna ukuhlinzwa kokufakelwa inhliziyo kufanele zihlangabezane nemibandela ethile yezokwelapha ukuze zithathwe njengabafanelekayo. Odokotela bahlola abangaba abamukeli ngokusekelwe ezicini ezimbalwa ezibalulekile ukuze baqinisekise imiphumela engcono kakhulu engenzeka.

Umuntu ufaneleka ukuthi ahlinzwe ukufakelwa inhliziyo lapho ehlangabezana nalezi zindlela ezibalulekile:

• Ubudala bungaphansi kweminyaka engama-69
• Kuhlonzwe ngesifo senhliziyo esisekupheleni
• Engcupheni yokufa phakathi nonyaka owodwa ngaphandle a ukufakelwa
• Ukubonisa izimpawu ngesikhathi sokusebenza okuncane noma ukuphumula (Isigaba IIIB kuya ku-IV isifo senhliziyo)

I-National Organ & Tissue Transplant Organisation (NOTTO) ihlukanisa abangaba abamukeli ngamaleveli amathathu abalulekile:

• Okubalulekile 1 (Ezimo Eziphuthumayo): Iziguli eziku-ventricular zisiza amadivayisi ahlala esesimweni esibucayi. 
• Okubalulekile 2 (Semi-emergency): Iziguli ekunakekelweni okukhulu ezidinga ukwesekwa kwe-ionotropic okungenani isonto. 
• Okubalulekile 3 (Okukhethekile): Iziguli ezilinde ukufakelwa kabusha ngendlela ekhethiwe

Nokho, izimo ezithile zingenza umuntu angafaneleki ukuhlinzwa okufakelwa inhliziyo. Lokhu kufaka phakathi ukuba nesinye isimo sezempilo esibucayi esingakhawulela isikhathi sokuphila, izifo ezisebenzayo, umlando wakamuva womdlavuza, noma ukungafuni ukwenza izinguquko ezidingekayo endleleni yokuphila.

Isinqumo sokuqhubeka nokuhlinzwa kokufakelwa kwenhliziyo sidinga ukuhlolwa ngokucophelela yiqembu lokufakelwa. Leli thimba licabangela isimo sempilo yesiguli sisonke, umlando wezokwelapha, kanye nekhono lokuthobelana nezidingo zokunakekelwa kwangemva kokufakelwa. Ukufakelwa kwenhliziyo kungenzeka kuphela kubanikeli abashone ebuchosheni, okwenza ukutholakala kwezitho ezifanelekile kube isici esibalulekile kule nqubo.

Yiziphi Izingozi Ezihambisana Nokuhlinzwa Kokufakelwa Kwenhliziyo?

Izingozi ezibaluleke kakhulu ezihlobene nokuhlinzwa kokufakelwa kwenhliziyo zihlanganisa:

• Ukwenqatshwa Kwezitho: Amasosha omzimba angase azame ukwenqaba inhliziyo yomuntu onikelayo, edinga imithi yokuzivikela evikela impilo yonke.
• I-Primary Graft Failure: Lesi simo, lapho inhliziyo yomnikeli ingasebenzi kahle, yisona sizathu esivame kakhulu sokufa ezinyangeni ezimbalwa zokuqala ngemva kokufakelwa.
• Izinkinga ze-Arterial: Izindonga zemithambo yenhliziyo zingajiya futhi zibe lukhuni, okuholela ezinkingeni zokujikeleza kwegazi kanye nokuhlaselwa yinhliziyo okungenzeka.
• Ingozi Yokutheleleka: Ngenxa yemithi yokuzivikela komzimba, iziguli zibhekana nengozi eyengeziwe yokutheleleka, ngokuvamile okudinga ukulaliswa esibhedlela ngonyaka wokuqala.
• Ingozi Yomdlavuza: Imithi edingekayo yokuvikela umzimba ingakhuphula amathuba okuba nomdlavuza othile, ikakhulukazi umdlavuza wesikhumba kanye nowe-non-Hodgkin's. i-lymphoma

Amaqembu ezokwelapha aqapha ngokucophelela iziguli ngalezi zinkinga, ikakhulukazi ezinyangeni ezimbalwa zokuqala ezibalulekile ngemva kokuhlinzwa. Isikhathi esiphezulu sengozi senzeka phakathi nezinyanga zokuqala kulandela inqubo, nakuba ukuqapha kwesikhathi eside kusabalulekile.

Isiphetho

Ukuhlinzwa kokufakelwa kwenhliziyo kuseyinqubo ebalulekile esindisa impilo ezigulini ezinezimo ezinzima zenhliziyo. Iziguli kufanele zicabangele kokubili izindleko zokuhlinzwa ezisheshayo kanye nezindleko zesikhathi eside njengemithi evimbela ukwenqatshwa kanye nokuhlolwa okuvamile.

Amazinga empumelelo athuthukile ngokuhamba kweminyaka, amazinga okusinda onyaka owodwa afinyelela ku-85-90% ezigulini ezikhethwe ngokucophelela. Kodwa-ke, inqubo ithwala izingozi ezinjengokwaliwa kwesitho kanye nezifo, ezidinga ukuphathwa kwempilo yonke kanye nezinguquko zokuphila.

Iziguli ezicabanga ngokuhlinzwa kokufakelwa kabusha kwenhliziyo kufanele ziqale ngokuxoxa nodokotela ngezinketho zazo. Ukuqonda ukuhlukaniswa kwezindleko okuphelele, imibandela yokufaneleka, nezimfuneko zokunakekelwa kwangemva kokuhlinzwa kusiza imindeni yenze izinqumo ezinolwazi mayelana nale nqubo eshintsha impilo.

Uhambo lokuhlinzwa kokufakelwa kwenhliziyo ludinga ukuzibophezela, kodwa intuthuko yesimanje yezokwelapha ikwenze kwaba inketho ethembekile kulabo abanesifo senhliziyo esifika ekugcineni. Ukulungiselela kahle, kokubili ngokwezimali nangokwezokwelapha, kunendima ebalulekile ekuzuzeni imiphumela emihle.

Disclaimer

Imininingwane yezindleko nezilinganiso ezinikezwe kule webhusayithi ezezinjongo zokwaziswa kuphela futhi zisekelwe ezimweni ezimaphakathi. Azihlanganisi isilinganiso esinqunyiwe noma isiqinisekiso sezindleko zokugcina.

Izibhedlela ze-CARE azimeli noma azikukhuthazi ukuqiniseka kwalezi zibalo zezindleko. Izindleko zakho zangempela zizohluka ngokuya ngohlobo lokwelashwa, izinsiza ezikhethiwe noma izinsizakalo, indawo yesibhedlela, impilo yesiguli, ukuhlinzekwa komshwalense, kanye nezidingo zezokwelapha ezinqunywe udokotela wakho. Ukusebenzisa kwakho okuqukethwe kwale webhusayithi kusho ukuthi uyakwamukela futhi wamukele lokhu kuhlukahluka nokuthi noma yikuphi ukuthembela ezindlekweni ezilinganiselwe kuzifaka engozini ngokwakho. Ukuze uthole ulwazi lwezindleko lwamanje kakhulu nolwenzelwe wena siqu, sicela usithinte ngokuqondile noma usishayele.

Imibuzo Evame Ukubuzwa

1. Ingabe ukufakelwa inhliziyo kuwukuhlinzwa okuyingozi enkulu?

Ukufakelwa kwenhliziyo kuthathwa njengenqubo enobungozi obukhulu ngenxa yezinkinga ezingase zibe khona. Ukuhlinzwa kunezingozi zokopha, ukutheleleka, amahlule egazi, nokwenqatshwa kwesitho. Ucwaningo lubonisa ukuthi izinga lokufa kokuhlinzwa laliphakathi kuka-5-10% kusukela ngo-2011.

2. Kuthatha isikhathi esingakanani ukululama ekufakweni kwenhliziyo?

Ukululama ngokuvamile kuthatha amasonto ayisithupha kuya kwayisishiyagalombili ukuze ukusika kuphole. Iziguli eziningi ziqala ukuzizwa ziphilile futhi zinamandla futhi ngemva kwezinyanga eziyisithupha. Ukuhlala esibhedlela kokuqala ngokuvamile kuthatha izinsuku eziyi-10-14.

3. Ingabe ukufakelwa inhliziyo kuwukuhlinzwa okukhulu?

Yebo, ukufakelwa inhliziyo kuwumsebenzi omkhulu odinga izindlela zokuhlinza eziyinkimbinkimbi. Kuhilela ukuvula imbobo yesifuba nokuxhuma isiguli emshinini wokunqamula inhliziyo namaphaphu phakathi nenqubo.

4. Kubuhlungu kangakanani ukuhlinzwa kokufakelwa inhliziyo?

Iziguli zizwa ubuhlungu lapho zivuka ekuhlinzweni, kodwa amaqembu ezokwelapha ahlinzeka ngokulawula izinhlungu ngempumelelo ngemithi. Ithimba lokufakelwa liklama izinhlelo ezithile zokulawula ubuhlungu ukuze kugcinwe iziguli zikhululekile ngesikhathi sokululama.

5. Ukuhlinzwa kokufakelwa inhliziyo kuthatha isikhathi esingakanani?

Ukusebenza ngokuvamile kuthatha phakathi kwamahora ayisithupha nayishumi nambili. Isikhathi esiqondile sokuhlinzwa kokufakelwa kwenhliziyo sincike ezintweni ezihlukahlukene, kuhlanganise nokuthi isiguli sike sahlinzwa yini inhliziyo ngaphambilini.

6. Ubani onganikela ngenhliziyo?

Abanikeli abafile ubuchopho kuphela abanganikeza izinhliziyo zokufakelwa kabusha. Inhliziyo yomnikeli kufanele ihlangabezane nemibandela eqinile:

• Ukuhambisana kohlobo lwegazi nomamukeli
• Usayizi ofanayo phakathi kuka-20% wosayizi womamukeli
• Iminyaka yomnikeli nezimo zempilo
• Ibanga lendawo lokuthutha

Ngemuva kokuhlinzwa, iziguli zidinga ukunakekelwa kanye nokuqapha impilo yonke ukuze zigweme ukwenqatshwa futhi zigcine impilo yenhliziyo yazo entsha.