gadanergili-organo gadarCenili sicocxle!

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!