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Gadanergili-organo gadarCenili sicocxle! Tirkmlis transplantacia.

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Presentation on theme: "Gadanergili-organo gadarCenili sicocxle! Tirkmlis transplantacia."— Presentation transcript:

1 gadanergili-organo gadarCenili sicocxle! Tirkmlis transplantacia

2 Tirkmeli – adamianis ZiriTadi eqskretoruli organo

3 daSlis produqtebiT mdidari sisxli Tirkmels arteriiT miewodeba da ifiltreba sisxlis filtratia Sardi Sardi SardsawveTiT Sardis buStSi grovdeba da SardsadeniT gareT gamoiyofa

4 Tirkmlebi ganlagebulia retroperitonealur sivrceSi, gulmkerdis XI da welis III malebis doneze Tirkmlis masa gr. sirZe sm. sigane 5-6 sm. sisqe 3-4 sm.

5 Tirkmeli Sedgeba gareTa-qerqovani da SigniTa-tvinovani Sreebisagan Tirkmlis ZiriTad struqturul-funqciur erTeuls warmoadgens nefroni

6 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

7 Tirkmlis mwvave da qronikuli ukmarisoba irRveva Tirmlis funqciebi wyalmarilovani, azotovani da sxva nivTerebaTa cvla Tirkmlis mwvave ukmarisoba irRveva filtraciuli, gamomyofi da sekretoruli funqciebi

8 Tirkmlis qronikuli ukmarisobis mizezi SeiZleba iyos: yvla is daavadeba, romelic iwvevs Tirkmlis gorglebis dazianebas

9 Tirkmlis qronikul ukmarisobas iwveven Semdegi daavadebebi Tirkmlebis polikistozi arteriuli hipertenzia qronikuli glomerulonefriti, pielonefriti sistemuri wiTeli mglura, hemoragiuli vaskuliti Saqriani diabeti, podagra, amiloidozi

10 Tirkmlis qronikul ukmarisobas iwveven Semdegi daavadebebi SardkenWovani daava- deba, hidronefrozi Tirkmlis ganviTa- rebis Tandayolili anomaliebi Sardsadenze zemwoli simsivne

11 TirkmliT CanacvlebiTi Terapiis ori forma dializi transplantacia

12 Tirkmlis pirveli gadanergva 1902 w. uremiiT daavadebuls gadaunerges Roris Tirkmeli 1933 w. gadainerga gardacvlili adamianis Tirkmeli 1954 warmatebiT gadainerga gardacvlili adamianis Tirkmeli

13 swored miureis naSromebi daedo safuZvlad Tanamedrove transplantologias warmatebuli operaciisTvis ozef miurem 1990 wels nobelis premia miiRo

14 Tirkmlis gadanergva saqarTveloSi 1977 w. gadainerga gvamuri Tirkmeli 1997 w. daarsda transplantologTa asociacia

15 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

16 imunosupresiuli preparatebia azatiopriniprednizoloniciklosporini

17 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

18 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

19 yvela donorma unda gaiaros fsoqosocialuri gamokvleva, Tirkmlis gacemis motivaciis Sesafaseblad

20 recipienti-adamiani, romelsac energeba qsovili an organo

21 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

22 recipienti, rogorc donori, srulad unda iyos informirebuli yvela mosalodneli garTulebis Sesaxeb

23 operaciis dawyebamde xeli unda moaweroT Tanxmobis formaze, romelic adasturebs Tqvens Tanxmobas Tirkmlis gadanergvis operaciaze

24 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

25 saoperacio velis kans daamuSaveben Zlieri antiseptikuri xsnariT eqimi avlbes grZel ganakveTs muclis qvemoT cal mxareze

26 donoris Tirkmels aTavseben muclis RruSi donoruli Tirkmlis SardsawveTs uerTeben Sardis buSts donoruli Tirkmlis arteriasa da venas uerTeben pacientis TeZos arteriasa da venas

27 donoris marjvena Tirkmeli marcxniv inergeba, xolo marcxena-marjvniv; amiT advili xdeba donoruli Tirkmlis SardsawveTis mierTeba Sardis buStTan

28 ganakveTs keraven qirurgiuli nakeriT SeSupebis Sesamcireblad ganakveTis ubanSi Tavsdeba drenaJi Wrilobas adeben sterilur saxvevs

29 c Tirkmlis gadanergvis operaciis Semdeg pacients awvenen intensiuri Terapiis an reanimaciis palataSi, mdgomareobis gaumjobesebis Semdeg gadayavT Cveulebriv palataSi

30 operaciis Semdeg pacients eniSneba medikamentebi, raTa organos mwvave mocilebis reaqcia ar ganviTardes

31 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

32 qronikuli mocilebis sindromi medikamentozuri intoqsikacia transplantis qronikuli nefropaTia rekurentuli daavadeba Tirkmlis transplantantis daavadebebi

33 msoflio statistikis Tanaxmad, gadanergili Tirkmlis funqcionirebis maqsimaluri xangrZlivoba welia

34 gisurvebT janmrTelobas!


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