肾衰竭原因
肾衰竭最常见的原因包括:
肾移植评价
在肾移植评估期间, a 移植协调员 will arrange a series of tests to assess your treatment options. 你会被评估潜在的健康问题,比如心脏病, 感染, 膀胱功能障碍, 溃疡和肥胖. 社工将讨论交通问题, 住房, financial and family support needs in regard to a transplant and a financial counselor will address the benefits of your insurance policy.
We want you to learn as much as possible about the transplant process before making a decision.
筛选试验
不管你是否会从活着的或死去的捐赠者那里得到肾脏, you'll need to undergo special blood tests to determine your blood and tissue type. 这些测试能帮你找到合适的肾脏.
血型. 第一次测试确定血型. 有四种血型:A型、B型、AB型和O型. The recipient and donor must have either the same blood type or compatible types.
- 如果你的血型是A型,那么献血者的血型必须是A型或O型
- 如果你的血型是B型,那么献血者的血型必须是B型或O型
- If your blood type is AB (universal recipient), donor blood type may be A, B, AB or O
- 如果你的血型是O型(万能型),那么献血者的血型必须是O型
AB型血, 被称为通用接受者, 是否最容易匹配,因为个体接受所有血型. O型血,被称为万能供体,是最难匹配的. 尽管O型血的人可以捐献给所有类型的人, 他们只能接受O型血捐献者的肾脏. 例如, 如果一个O型血的病人移植了a型血的肾脏, 身体会把供体的肾脏识别为外来的,并将其摧毁.
Rh血型(+,-)不是供体匹配的一个因素.
人白细胞抗原(HLA). The second test is a blood test for human leukocyte antigens (HLA), called tissue typing. These antigens are found on many cells of the body, but are mostly seen on white blood cells. 家族成员之间的组织类型相似性可能是100%、50%或0%. 在选择供体时要考虑所有潜在供体的组织类型.
所有潜在捐赠者, 无论他们是否与收件人有关系, 能安排做组织分型测试吗. 无需特别准备,两周内可获得结果. Pre-packaged kits with instructions to collect and return blood samples are available for potential donors who don't live nearby. Blood can be drawn at a local doctor's office or hospital laboratory and sent to the UCSF Transplant Service via overnight mail.
试验. 免疫系统产生一种叫做抗体的蛋白质, 它们会攻击细菌和病毒等外来物质. 当你受到感染时,你会产生抗体, 怀孕, 输血或接受肾脏移植. 如果你对供体肾脏有抗体,你的身体会破坏肾脏. To ensure that you don't already have antibodies to the donor, we conduct a test called a crossmatch.
为了进行交叉配型,我们把你的血液和捐献者的细胞混合在一起. 如果交叉匹配是正的, you have antibodies against the donor and should not receive the person's kidney. 如果交叉匹配是负的, you don't have antibodies to the donor and you're eligible to receive the kidney.
试验es are performed several times during preparation for a living-related donor transplant, 特别是在使用特定供者输血的情况下. 移植前48小时内进行最后一次交叉配型.
血清学. 对潜在的传染性疾病进行检测, 例如艾滋病毒(人体免疫缺陷病毒), 肝炎和巨细胞病毒.
移植的资格
当评估完成时, 移植小组将会面, discuss your medical and social history and decide whether or not to place you on the transplant waiting list. This decision is made only after discussing your situation with a nephrologist (kidney specialist), 外科十大赌博平台排行榜, 移植协调员, 社会工作者和财务顾问.
如果你是移植候选人, you will be placed on the waiting list of the United Network for Organ Sharing (UNOS). 如果移植不符合你的最佳利益, 移植团队的成员会和你讨论其他选择.
People who are 60 years of age and older are considered for transplant on an individual basis after medical and cardiovascular evaluation. People with anatomically abnormal urinary tracts may not qualify until they've undergone appropriate reconstructive surgery.
如果你有以下情况,你可能不符合肾脏移植的十大赌博靠谱网络平台:
- 最近得了癌症
- 最近心脏病发作
- 最近滥用药物或酒精
- 活动性感染
肾移植等候名单
生活捐助者
Kidneys for transplant may come from either a living donor or deceased (cadaver) donor. 要了解更多关于活体供体的评估和手术,请访问 活体肾移植.
已故捐赠人
The Uniform Anatomical Gift Act allows people to donate organs for transplant when they die and allows their families to provide permission as well. 所有捐赠者都经过仔细筛选,以防止疾病传播.
If you decide to undergo a cadaveric kidney transplant and you're medically eligible, 你的名字会被列在尸体器官等待名单上. 抗体水平的血液样本将每月送到医疗中心. The waiting period depends upon the availability of a cadaver donor compatible with your blood type and your antibody level.
When a kidney becomes available, your kidney specialist is contacted for approval. UCSF's transplant service will verify that you have no recent 感染 or medical problems that would interfere with a safe transplant. 我们会帮你安排移植手术.
肾移植手术
你的手术会持续两到四个小时. 操作过程中, the transplanted kidney is placed in your pelvis rather than the usual location in the back. (你自己的肾脏不会被切除.) The artery that carries blood to the kidney and the vein that carries blood out of it are surgically connected to two blood vessels in the pelvis. 输尿管, 或将尿液从肾脏输送到膀胱的管道, 是通过膀胱的切口移植的吗.
手术后, you will remain in the recovery room for a few hours and then return to the 肾移植 Unit. 手术结束后,外科十大赌博平台排行榜会通知你的家人.
You will be encouraged to get out of bed 12 to 24 hours after surgery and walk as much as you can. 护士会指导你服药, 解释副作用并讨论如何改变生活方式.
尸体肾脏的功能可能暂时迟缓, 这种情况被称为“困倦肾”或急性肾小管坏死. 困倦的肾脏通常在两到四周内开始工作. 在那之前,你可能需要进行几次透析.
Most transplant recipients must take medications called immunosuppressants to prevent the body from rejecting the transplanted organ. One of the side effects of these drugs is an increased risk for cancer, particularly 皮肤癌 和淋巴瘤. 你应该密切关注这些情况.