Odokotela Sebeshintshe Umbono Ngokuhlinza Ngaphandle Kwegazi

UJANET, owesifazane waseCanada, wachazela indodana yakhe ukuthi kungani enengculaza. Wayethole lesi sifo kumyeni wakhe ngaphambi kokuba afe. Kanti umyeni wakhe, owayenesifo sokopha, cishe wathola ingculaza ngokumpontshelwa igazi. Izimo ezethusayo njengalesi zingezinye zezici eziye zashukumisela abezokwelapha ukuba bawubheke ngelinye iso umkhuba wokumpompela abantu igazi. Empeleni, isihloko esikhulu se-New York Times nonyaka sathi: “Ukuhlinza ‘Ngaphandle Kwegazi’ Kwamukelwa Kabusha.”

Izingqungquthela eziningi zezokwelapha ziye zaqokomisa isithakazelo esikhulayo ekuhlinzeni ngaphandle kwegazi. Phakathi kwezingqungquthela ezibe khona nyakenye, ezimbili zazise-United States (eBoston nase-Atlanta), enye eCanada (eWinnipeg), kanti enye yayiseLatvia (eRiga), okwakuyingqungquthela yawo wonke amazwe aseMpumalanga Yurophu.

Ngemva kweminyaka engaphezu kwengu-50 bethembele ekumpompeleni igazi, kungani ochwepheshe abangaphezu kuka-1400 basemazweni angu-12 baba khona kulezi zingqungquthela ezine ezaziveza ukuthi ukuhlinza ngaphandle kwegazi “kuyindlela edl’ubhedu,” njengoba kwasho esinye isihloko sephephandaba? Lezi zingqungquthela zaqokomisani ngokuphathelene nemithi emisha, imishini nezinqubo zokwelapha ezingathinta ukwelashwa okukhethwa umkhaya wakho?

Kungani Kufunwa Ezinye Izindlela?

Isizathu esiyinhloko siwukuhluleka ukuvikela igazi elithekeliswayo. Ngokwesibonelo, i-Globe and Mail yaseToronto, ka-January 31, 1998, isho lokhu “ngenhlekelele [yawo-1980] yegazi elinezifo” eCanada: “Ukusha Kwesibindi kohlobo C kuyisifo sesibindi esibi esingenalo ikhambi. . . . Abantu baseCanada abangafinyelela ku-60 000 kungenzeka bathola leli gciwane egazini elinezifo, okusho ukuthi abangaba ngu-12 000 bangase babulawe ukusha kwesibindi okubangelwe igazi.”

Nakuba izindlela ezintsha zokuhlola igazi ziye zalunciphisa kakhulu usongo, uMahlulel’uHorace Krever watshela ababebuthene engqungqutheleni yaseWinnipeg ukuthi: “Igazi elithekeliswayo eCanada alikaze neze liphephe ngokuphelele, futhi alisoze laba njalo. Ukusebenzisa igazi kuhilela izingozi ezingenakugwenywa.” Futhi izingozi zokuthola izifo noma zokubangela ukuphazamiseka okukhulu ziyanda ngokumpontshelwa kwephayindi ngalinye legazi.

ERiga, uDkt. Jean-Marc Debue, waseClinique des Maussins, eParis, waphetha ngokuthi: “Kuye kwadingeka ukuba thina bodokotela siyibheke ngelinye iso inqubo yethu yokwelapha evamile. . . . Ukumpontshelwa igazi kuye kwandisa isikhathi sokuphila kwabantu abaningi, kodwa kuye konakalisa nokuphila kwabanye ngokubabangela izifo ezingelapheki.”

Izindlela zokuhlola ukuthi igazi alinawo yini amagciwane azihambisani nezinsongo zezifo ezintsha futhi kanjalo zingase zingabavikeli abantu kuzo. Ngokwesibonelo, uDkt. Paul Gully, wase-Ottawa, e-Ontario, eCanada, waphawula: “Ukusha Kwesibindi kohlobo G kuyigciwane le-RNA elisanda kutholakala; kuye kwadluliswa ngokumpontshelwa kodwa ukuthi ingozi ekhona okwamanje ingakanani akwaziwa.”

Enye ingozi yabikwa kumagazini okhethekile wezokwelapha we-Time: “Ukumpontshelwa igazi kungaphazamisa isimiso somzimba sokuzivikela ezifweni, . . . okungachaya isiguli ezifweni futhi kusenze sephuze ukululama.”

Esinye isici siwukonga izimali. Ngokukamagazini i-Time, ukumpontshelwa igazi ngakunye e-United States kungabiza u-$500 (R3200). Kanti kwezinye izindawo, igazi eligciniwe liyaphela ngoba bambalwa abathekelisa ngalo.

Enye inzuzo etholwa iziguli ezihlinzwa ngaphandle kwegazi iwukuthi azingenwa yizifo kakhulu futhi zihlala isikhathi esifushane esibhedlela. Ekhuluma eWinnipeg, uDurhane Wong-Rieger, we-Canadian Hemophilia Society, washo lokhu ngokuhlinza ngaphandle kwegazi: “Sinomuzwa wokuthi kubalulekile. Konga imali futhi ngokuqinisekile kuyoyithuthukisa impilo yeziguli.”

Iziguli eziningi ngokwengeziwe zifuna ukuhlinzwa ngaphandle kwegazi. UDkt. David Rosencrantz, weLegacy Portland Hospitals (e-Oregon, e-U.S.A.), wathi ekuqaleni “bonke abantu ababeza kithi babeza ngenxa yezizathu zenkolo.” Nokho, manje okungenani abangamaphesenti angu-15 bakhetha ezinye izindlela zokwelashwa kunokumpontshelwa igazi, kodwa hhayi ngenxa yezizathu zenkolo.

Imibono Ehlukahlukene

Kulezi zingqungquthela ezine, iphuzu eliyinhloko okwavunyelwana ngalo laliwukuthi ukusebenzisa komuntu igazi lakhe siqu kuphephe kakhulu kunokusebenzisa igazi elithekeliswe abanye abantu. Ngenxa yalokhu, abanye batusa ukuba umuntu agcinelwe igazi lakhe ngaphambi kokuba ahlinzwe. Nokho, abaningi baphawula ukuthi asikho isikhathi sokugcina igazi lapho izimo ziphuthuma. Futhi, oFakazi BakaJehova bayakwenqaba ngezizathu zenkolo ukusebenzisa noma yiliphi igazi eligciniwe.a

UDkt. Bruce Leone, waseDuke University, eNyakatho Carolina, e-U.S.A., watshela ababebuthene engqungqutheleni yaseCanada: “Ukuthekelisa [komuntu ngegazi lakhe] ngaphambi kokuhlinzwa kuyabiza, kuwumsebenzi omkhulu, akuziqedi izimbangela ezivamile zokwesaba okuhambisana nokumpontshelwa [okuyiphutha lokugcinwa kwamarekhodi—okuwukuthi iphutha lehhovisi noma lezinqubo] futhi kudinga isikhathi esiningi ngaphambi kokuhlinzwa.”

Odokotela abaningi basekela ukuba kuqhutshekwe kwenziwa imithi nezinqubo ezikunciphisa kakhulu ukusetshenziswa kwegazi elimpontshelwayo. Bama kwelokuthi ukumpontshelwa igazi kufanele kusetshenziswe kuphela ezimweni eziphuthumayo. Ngakolunye uhlangothi, abanye manje abasalimpompeli nhlobo igazi uma belapha. Bakhomba izinqubo zokuhlinza ezinzima kakhulu—ukushintsha inqulu, ukuhlinza izinzwa okuyinkimbinkimbi, ukuhlinza inhliziyo ezinsaneni nakubantu abadala—ezenziwa ngaphandle kokumpompela igazi, lapho iziguli zilulama khona ngokushesha.

Okwamanje, kunezibhedlela ezingaphezu kwekhulu emhlabeni wonke ezelapha ngaphandle kwegazi, ezingu-70 zazo zise-United States. Eqinisweni, manje sekunodokotela abangaphezu kuka-88 000 emhlabeni wonke ababambisana neziguli ezingalifuni igazi.

Izinqubo Ezintsha

Engqungqutheleni yase-Atlanta, izikhulumi eziningi zavuma ukuthi zasungula inqubo entsha lapho ziqala ukwelapha oFakazi BakaJehova.b Abaningi bavumelana nombono kaDkt. James Schick, wase-Encino-Tarzana Regional Medical Center, eLos Angeles, owaphawula ukuthi ngenxa yezinqubo ezintsha ezasungulwa lapho kwelashwa izinsana zoFakazi BakaJehova ezazizalwe ngaphambi kwesikhathi, manje usesebenzisa isigamu segazi ayelisebenzisa ekwelapheni zonke izinsana eziyiziguli zakhe. Yiqiniso, izinqubo ezinjalo ezintsha ziye zaba usizo nakubantu abadala.

UDkt. Jean-François Hardy, wase-Montreal Heart Institute, waphawula: “Ukuhlinza ngaphandle kwegazi akunakwenziwa ngenqubo eyodwa vó yezokwelapha . . . Kunalokho, lo mgomo ungafinyelelwa kuphela ngokuhlanganisa izinqubo ezihlukahlukene.”

Phakathi kwalezi zinqubo ezintsha kubalwa (1) ukulungiselela ngaphambi kokuhlinzwa, (2) ukunqanda ukopha ngesikhathi sokuhlinza, kanye (3) nokunakekelwa ngemva kokuhlinzwa. Kusobala ukuthi zonke izinqubo zokuhlinza zithonywa kakhulu isikhathi, okuwukuthi, ingabe sikhona yini isikhathi sokwandisa izinga legazi lesiguli ngaphambi kokuhlinzwa noma asikho ngoba kumelwe sihlinzwe ngokuphuthumayo.

Indlela ephumelelayo yokuhlinzwa ngaphandle kwegazi iwukwelashwa ngaphambi kokuhlinzwa ukuze kwandiswe amangqamuzana egazi abomvu futhi kuthuthukiswe nesimo sempilo. Lokhu kuhlanganisa izithasiselo ezinothe ngokusansimbi kanye namavithamini, futhi lapho kufaneleke khona, ne-erythropoietin yokwenziwa, okuwumuthi oshukumisa umnkantsha womuntu ukuba ukhiqize amangqamuzana egazi abomvu ngokushesha. Imishini yobuchwepheshe yokuhlaziya isimo ngokucophelela ivumela ukuba kuthathwe igazi elincane elizohlolwa kodwa kutholakale imiphumela eminingi lapho lihlolwa. Lokhu kubalulekile ezinsaneni ezizalwe ngaphambi kwesikhathi nakubantu abadala abasuke sebelahlekelwe igazi eliningi.

Okunye futhi okuwusizo imithi eyandisa umthamo wegazi, ewuketshezi olufakwa ngemithambo. Kwezinye izikhungo kusetshenziswa negumbi elinezinga lomoya-mpilo eliphakeme ukuze kwandiswe umoya-mpilo isiguli esiye sopha kakhulu esiwudingayo. E-Atlanta, uDkt. Robert Bartlett wachaza ukuthi leli gumbi lomoya-mpilo liyithuluzi eliyigugu kakhulu kodwa kumelwe lisetshenziswe ngokucophelela ngoba umoya-mpilo omningi kakhulu uyingozi.

Ngokuphathelene nesinyathelo sesibili, esiwukunqanda ukopha phakathi nokuhlinza, kunamathuluzi nezindlela ezintsha ezihlukahlukene. Zinciphisa ukopha; zenza ukuba umzimba ungasikwa kakhulu, okunciphisa ukopha nokwethuka; noma zisiza ngokulibamba ngokushesha ziphinde zilisebenzise igazi isiguli ebesingalahlekelwa yilo phakathi nokuhlinzwa. Ake ucabangele ezimbalwa nje zalezi zinqubo ezintsha.

◼ Umshini kagesi wokushisa ulwelwesi usebenzisa ukushisa ukuze uvimbele ukopha kwemithambo.

◼ Umshini wokujiyisa igazi onemisebe ye-argon usiza ekunqandeni ukopha phakathi nokuhlinzwa.

◼ Ummese we-harmonic uyandindizelayo futhi ukhuhle ukuze usike izicubu futhi ujiyise igazi cishe ngesikhathi esifanayo.

◼ Ngezinye izikhathi lapho kuhlinzwa, ngokuvamile kusetshenziswa imithi enjenge-asidi i-tranexamic ne-desmopressin ukuze kujiyiswe igazi futhi kuncishiswe ukopha.

◼ Imithi yokubulala izinzwa inciphisa ukopha ngokwehlisa umfutho wegazi.

Okunye okuphawulekayo ukuthuthukiswa kwemishini esetshenziswa phakathi nokuhlinza eyonga igazi. Phakathi nokuhlinza, le mishini ibamba futhi ngokushesha iphinde isebenzise igazi lesiguli ngokwaso, ngaphandle kokuligcina.c Imishini emisha, nakuba ihlala ixhunywe kogulayo, ingahlukanisa ngisho negazi ngokwezakhi zalo futhi iphinde isebenzise lezo ezidingekayo.

Ngemva kwengqungquthela eyayiseRiga, nalapho bezwa ngesidingo saseLatvia, oFakazi BakaJehova eSweden banikeza iLatvia imishini emibili eyonga amangqamuzana egazi. Ukufika komshini wokuqala nezinzuzo zokuhlinza ngaphandle kwegazi kwathakazelisa abantu baseLatvia kangangokuba lesi senzakalo sasakazwa ngethelevishini ezweni lonke.

Ukunakekelwa ngemva kokuhlinzwa ngokuvamile kuhlanganisa nemithi eminingi efanayo yokwakha igazi esetshenziswa ekulungiseleleni ogulayo isikhathi sokuhlinzwa. Nokho, ukunakekela abantu abangampontshelwanga ngemva kokuhlinzwa ngokuvamile kulula kunokunakekela abampontshelwe. Ngani?

Imiphumela Ephawulekayo

Nakuba izinqubo ezingalisebenzisi igazi zihilela umsebenzi omkhulu ngaphambi kokuhlinzwa nalapho sekuhlinzwa, odokotela abahlinzayo baye baphawula ukuthi iziguli ziyazuza ngenxa yokululama ngokushesha ngemva kokuhlinzwa. Azibhekani nezinkinga ezivame ukulandela ngemva kokumpontshelwa. Kuye kwagcinwa amarekhodi eziguli ezihlala isikhathi esifushane esibhedlela ezazingazange zinikwe igazi.

UDkt. Todd Rosengart, waseNew York Hospital-Cornell University Medical Center, waphawula ukuthi inqubo yabo yokulondoloza igazi enezinyathelo ezingu-8 yayivumela ukuba kwenziwe ukuhlinzwa kwenhliziyo okuyinkimbinkimbi ngokuqiniseka ngaphandle kokusebenzisa igazi. UDkt. Manuel Estioko, waseGood Samaritan Hospital eLos Angeles, wathi “base bengomakad’ebona ekuhlinzeni izinhliziyo zabantu abaningi ngaphandle kwegazi.” UDkt. S. Subramanian wabika ukuthi ukuhlinzwa kwezinhliziyo zezingane ngaphandle kwegazi kwakuphumelela eMiami Children’s Hospital.

Ukuhlinzwa kwamathambo, ikakhulukazi ukushintshwa kwenqulu, kuwumkhakha oyinselele. Kodwa, uDkt. Olle Hägg, wase-Uddevalla Hospital eSweden, wabika eRiga ukuthi ukuhlanganisa “ubuciko bokuhlinza nokucophelela” kwakubenze bakwazi ukunciphisa ukopha ezigulini ezingoFakazi BakaJehova. Yebo, uMnu. Richard R. R. H. Coombs, wase-Imperial College School of Medicine, eLondon, wathi “amaphesenti angu-99,9 akho konke ukuhlinzwa kwamathambo angenziwa ngaphandle . . . kokumpompela igazi.”

Isikhathi Esizayo

Inani lezibhedlela nodokotela abangalisebenzisi igazi liyaqhubeka likhula. Kanti nezingqungquthela okucotshelelwana kuzo ulwazi olunjalo ziye zaba usizo kakhulu, njengoba odokotela befunda ezinye izindlela eziye zahlolwa zaphumelela futhi ezisetshenziswa njalo.

UDkt. Richard Nalick, wase-University of Southern California School of Medicine, wathi: “Kunenani elandayo labantu abafuna ukwelashwa nokuhlinzwa ngaphandle kwegazi . . . Ukwelapha nokuhlinza ngaphandle kwegazi kuyindlela yesimanje futhi akufanele kubhekwe ‘njengenye indlela yokwelapha’ engaphumeleli.”

Njengoba izinkinga eziphathelene nokumpontshelwa igazi ziqhubeka futhi nomphakathi uqhubeka ufuna ezinye izindlela, ikusasa lokuhlinza ngaphandle kwegazi libonakala liqhakazile.

[Imibhalo yaphansi]

[Isithombe ekhasini 20, 21]

Odokotela abaningi sebeyazihlonipha izifiso zeziguli ngokuphathelene nokuhlinzwa ngaphandle kwegazi