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gadanergili-organo gadarCenili sicocxle!
Tirkmlis transplantacia
Tirkmeli – adamianis ZiriTadi eqskretoruli
organo
daSlis produqtebiT mdidari sisxli Tirkmels arteriiT miewodeba da
ifiltreba sisxlis filtratia Sardi
Sardi SardsawveTiT Sardis buStSi grovdeba da SardsadeniT gareT gamoiyofa
• Tirkmlebi ganlagebulia retroperitonealur sivrceSi, gulmkerdis XI da welis III malebis doneze
• Tirkmlis masa 120-200 gr.
• sirZe 10-12 sm.• sigane 5-6 sm.• sisqe 3-4 sm.
Tirkmeli Sedgeba gareTa-qerqovani da SigniTa-tvinovani Sreebisagan
Tirkmlis ZiriTad struqturul-funqciur erTeuls warmoadgens nefroni
Tirkmlebis umniSvnelovanesi fiziologiuri roli-homeostazis
regulacia
osmoregulacia volumoregulacia eleqtrolituri da mJava-tutovani balansis
mudmivobis SenarCuneba azotovani cvlis produqtebis eqskrecia cilebis, lipidebis, naxSirwylebis
metabolizmSi monawileoba organizmidan toqsikuri nivTierebebis
gauvnebelyofa da gamoyofa hemodinamikis regulacia inkretoruli funqcia
Tirkmlis mwvave da qronikuli ukmarisoba
irRveva Tirmlis funqciebi• wyalmarilovani, azotovani
da sxva nivTerebaTa cvla Tirkmlis mwvave
ukmarisoba• irRveva filtraciuli,
gamomyofi da sekretoruli funqciebi
Tirkmlis qronikuli ukmarisobis mizezi SeiZleba iyos:
yvla is daavadeba, romelic iwvevs Tirkmlis gorglebis dazianebas
Tirkmlis qronikul ukmarisobas iwveven Semdegi daavadebebi
Tirkmlebis polikistozi
arteriuli hipertenzia
qronikuli glomerulonefriti, pielonefriti
sistemuri wiTeli mglura,hemoragiuli vaskuliti
Saqriani diabeti, podagra,amiloidozi
Tirkmlis qronikul ukmarisobas iwveven Semdegi daavadebebi
SardkenWovani daava-deba, hidronefrozi
Tirkmlis ganviTa-rebis Tandayolili anomaliebi
Sardsadenze zemwoli simsivne
TirkmliT CanacvlebiTi Terapiis ori forma
dializi transplantacia
Tirkmlis pirveli gadanergva
1902 w. uremiiT daavadebuls gadaunerges Roris Tirkmeli
1933 w. gadainerga gardacvlili adamianis Tirkmeli
1954 warmatebiT gadainerga gardacvlili adamianis Tirkmeli
swored miureis naSromebi daedo safuZvlad Tanamedrove transplantologias
warmatebuli operaciisTvis ozef miurem 1990 wels nobelis premia miiRo
Tirkmlis gadanergva saqarTveloSi
1977 w. gadainerga gvamuri Tirkmeli 1997 w. daarsda transplantologTa asociacia
0%
5%
10%
15%
20%
25%
30%
1995-1999
2000-2007
ლეტალუ რადდასრუ ლებუ ლი ოპერაციები
• 2010 w. 23 oqtombers Tbilisma pirvelad umaspinZla “organoTa donaciis me-12 evropul dRes”
• RonisZiebaSi monawileoba miiRo ormocamde eqim-transplantologma evrosabWos qveynebidan
organoTa donaciis me-12 evropuli dRe TbilisSi
imunosupresiuli preparatebia
azatioprini ciklosporiniprednizoloni
saqarTveloSi 2000 w. miRebuli kanonis Tanaxmad donori SeiZleba iyos, rogorc
cocxali, ise gardacvlili adamiani
» recipients SeiZleba gadaenergos mxolod genetikuri naTesavis, meuRlis, an meuRlis naTesavis organo
» saqarTveloSi moqmedebs ‘donorTa gacvlis programa’
» organoebiT vaWroba saqarTveloSi xuTidan aT wlamde Tavisuflebis aRkveTiT isjeba
donori-adamiani, romlis sxeulidanac iReben gadasanerg qsovils an organos
• sisxlis jgufis Tanxvedra, leikocituri antigenebisa da e.w. jvaredini reaqciis mixedviT
• erTmaneTis msgavsi unda iyos donorisa da recipientis masa da asaki
• sasurvelia Tirkmlis gadanergva erTi da imave sqesis adamianebs Soris moxdes
Tavsebadobis ZiriTadi parametrebi
yvela donorma unda gaiaros fsoqosocialuri gamokvleva, Tirkmlis
gacemis motivaciis Sesafaseblad
recipienti-adamiani, romelsac energeba qsovili an organo
gadanergvisaTvis saWiroa recipientis momzadeba
• unda mowesrigdes sisxlis bioqimiuri maCveneblebi, arteriuli wneva, gul-sisxlZarRvTa sistemis muSaoba
• aucelebelia ganikurnos yvela anTebiTi procesi
• sisxlSi eriTrocitebisa da hemoglobinis saTanado donis uzrunvelyofa
• donoris Tirkmlis Tavsebadobis dasadgenad unda Catardes antigenebisa da histoSeTavsebis sistemebis kompleqsuri gamokvleva
recipienti, rogorc donori,srulad unda iyos informirebuli
yvela mosalodneli garTulebis Sesaxeb
operaciis dawyebamde
xeli unda moaweroT Tanxmobis formaze, romelic adasturebs Tqvens Tanxmobas Tirkmlis gadanergvis operaciaze
operaciis mimdinareoba
operaciis dros wamlebis Sesayvanad pacients venaSi udgamen ramdenime kaTeters wveTovaniT
piridan filtvebSi SeyavT mili, romelic SeerTebulia filtvebis xelovnuri ventilaciis aparatTan
akontroleben gulis cemis sixSires, arteriul wnevas, sunTqvas
• saoperacio velis kans daamuSaveben Zlieri antiseptikuri xsnariT
• eqimi avlbes grZel ganakveTs muclis qvemoT cal mxareze
donoris Tirkmels aTavseben muclis RruSi
donoruli Tirkmlis SardsawveTs uerTeben Sardis buSts
donoruli Tirkmlis arteriasa da venas uerTeben pacientis TeZos arteriasa da venas
donoris marjvena Tirkmeli marcxniv inergeba, xolo
marcxena-marjvniv; amiT advili xdeba donoruli Tirkmlis
SardsawveTis mierTeba Sardis buStTan
ganakveTs keraven qirurgiuli nakeriT
SeSupebis Sesamcireblad ganakveTis ubanSi Tavsdeba drenaJi
Wrilobas adeben sterilur saxvevs
cTirkmlis gadanergvis operaciis Semdegpacients awvenen intensiuri Terapiis an
reanimaciis palataSi, mdgomareobis gaumjobesebis
Semdeg gadayavT Cveulebriv palataSi
operaciis Semdeg pacients eniSneba
medikamentebi, raTa organos
mwvave mocilebis reaqcia ar
ganviTardes
donorma erTxans Tavi unda aaridos zogierT sakvebs ( comeuls; mwares; cxares; marilians; alkoholur sasmelebs da sxva )
recipientisaTvis mniSvnelovania naoperaciebi midamos sufTad da mSralad SenarCuneba
Sin dabrunebis Semdeg
qronikuli mocilebis sindromi
medikamentozuri intoqsikacia
transplantis qronikuli nefropaTia
rekurentuli daavadeba
Tirkmlis transplantantis daavadebebi
msoflio statistikis Tanaxmad, gadanergili Tirkmlis funqcionirebis
maqsimaluri xangrZlivoba 20-30 welia
gisurvebT janmrTelobas!