Unyango Ngokutofela Igazi Ngaba Luya Kuqhubeka Lusetyenziswa?

“Ukutofela igazi kuza kufana nokuhamba kwihlathi elishinyeneyo, iindledlana zokuhamba ziyabonakala kodwa umntu ohamba kuzo ufanele achul’ ukunyathela, kusenokuba kukho izinto angakhange azibone neziyingozi ezincathame edolweni phayaa nezilindele ukwenzakalisa abo bangalumkanga.”—Utsho njalo uIan M. Franklin, unjingalwazi ngokuphathelele utofelo-gazi.

UKUQHAMBUKA kobhubhane uGawulayo kwabavul’ amehlo abantu ngokuphathelele igazi kwiminyaka yee-1980 yaye kwenziwa iinzame ezithe chatha zokuphelisa “iingozi ezingaziwayo.” Nangoku ke phofu, kusekho imiqobo emikhulu. NgoJuni 2005, iWorld Health Organization yavuma isithi: “Amathuba okutofelwa igazi elingenazintsholongwane . . . ahluka gqitha ukusuka kwelinye ilizwe ukuya kwelinye.” Ngoba?

Kumazwe amaninzi akuqinisekiswa ukuba igazi elifunyenweyo licocekile, yaye alixilongwa ukuqinisekisa ukuba alinazifo okanye alifuduselwa kwenye indawo ngendlela ekhuselekileyo. Ngamanye amaxesha, indlela eligcinwa ngayo igazi ibangel’ amasikizi—kusetyenziswa amagxokogxoko eefriji neebhaskiti ezaphukileyo! Ukuba akukho milinganiselo yempilo esemgangathweni, abantu basenokuguliswa ligazi lomntu ohlala kumgama oziikhilomitha ezingamakhulu—okanye ezingamawaka.

Igazi Elingenazifo—Kusekud’ Engqinibeni

Amanye amazwe athi elawo igazi likhuselekile kunangaphambili. Noko ke, sikho isizathu sokulumka. Iphephandaba elilungiselelwe ngamaziko amathathu egazi aseMerika, “iCirucular of Information,” lithi: “ISILUMKISO: Ngenxa yokuba igazi elipheleleyo neenxalenye eziphambili zegazi zenziwe ngegazi lomntu, zinokuba yingozi okanye zibe neentsholongwane. . . . Ukukhetha ngenyameko abantu abaza kunikezela ngegazi nokuhlolwa kwalo akuziphelisi iingozi zegazi.”

Wayengaphazami uPeter Carolan, igosa eliyintloko leInternational Federation of Red Cross and Red Crescent Societies, xa wathi: “Asikho isiqinisekiso sokuba igazi elinikelweyo licocekile.” Wongezelela ngelithi: “Kuya kusoloko kukho izifo ezitsha esingazi nokuba zihlolwa njani na.”

Kuthekani ke ukuba kukho isifo esingaziwayo, esihlala singabonakali ixesha elide nesidluliselwa lula ngegazi njengoGawulayo? Ethetha kwingqungquthela yoogqirha yasePrague, kwiRiphabliki yaseCzech, ngoAprili 2005, uGqr. G. Klein weU.S. National Institutes of Health uthi oku kuyothusa. Wongezelela esithi: “Abo baqokelela iinxalenye zegazi abanakukwazi ukumelana nobhubhane odluliselwa ngokutofela igazi njengaxa kwakunjalo ekuqaleni kukaGawulayo.”

Iimpazamo Nemiphumo Yokutofelwa Igazi

Ziziphi izinto ezisisisongelo kubantu abakumazwe asakhasayo ngenxa yokutofelwa igazi? Ziimpazamo kwindlela igazi eligcinwa ngayo noko kwenzekayo kwinkqubo yomzimba yokuzikhusela kwizifo emva kokutofelwa igazi. Lithetha ngohlolisiso olwenziwa eKhanada ngowama-2001, iphephandaba iGlobe and Mail lithi kuye kwaphantse kwenzeka iimpazamo ezinkulu ngenxa “yokutsala igazi lomnye umguli, ukuphawula igazi ngendlela engachananga, nokutofelwa kwegazi ngokungeyomfuneko.” Ezi mpazamo ziye zabulala abantu abangama-441 eUnited States ukususela ngowe-1995 ukusa kowama-2001.

Abo batofelwa igazi lomnye umntu bazibeka esichengeni njengomntu ofakelwa ilungu lomzimba. Inkqubo yomzimba yokuzikhusela idla ngokungalamkeli ilungu lomzimba lomnye umntu. Kwezinye iimeko, ukutofelwa igazi kunokuyenza ingasebenzi inkqubo yomzimba yokuzikhusela kwizifo. Ezi zinto zidodobalisa le nkqubo zishiya umguli esemngciphekweni wokufumana izifo nokuhlaselwa ziintsholongwane ebezingenamandla ngaphambili. Ngenxa yeso sizathu, uNjingalwazi Franklin ocatshulwe ngasentla, ukhuthaza abezonyango ukuba “bacinge kabini ngaphambi kokuba batofele igazi emntwini.”

Ingcali Zivelisa Izimvo Zazo

Ngenxa yolwazi olunjalo, inani elandayo labezonyango likujonga ngelinye iliso ukutofela igazi. Incwadi iDailey’s Notes on Blood ithi: “Abanye oogqirha bathi ukusebenzisa igazi lomnye umntu liyeza eliyingozi kwaye ukuba ukusetyenziswa kwalo bekujongwa ngendlela efanayo namanye amayeza, ukutofelwa kwegazi bekunokupheliswa.”

Ngasekupheleni kowama-2004, uNjingalwazi uBruce Spiess wathi ngokutofela iinxalenye eziphambili zegazi kumguli owenza uqhaqho lwentliziyo: “Ambalwa amanqaku [ezonyango] ukuba akho axhasa, ukutofelwa igazi njengento eluncedo kumguli.” Eneneni ubhala athi ukutofelwa igazi “kusenokuba yingozi kunokuba kube luncedo phantse kuzo zonke iimeko ngaphandle kwesihlandlo xa umntu eye wopha,” nto leyo eyandisa amathuba “okungenwa yinyumoniya, ukosulelwa zizifo, ukuhlaselwa sisifo sentliziyo kunye nokufa icala.”

Kuyabothusa abaninzi ukubona iindlela ezahluke ngayo iinkqubo zokutofela igazi. UGqr. Gabriel Pedraza mvanje ukhumbuze oogxa bakhe baseChile ukuba “ukutofel’ igazi yindlela engekho mgangathweni yonyango,” eyenza “kube nzima . . . ukusebenzisa iindlela zonyango ezamkelekileyo ehlabathini lonke.” Akothusi ke ngoko ukuva uBrian McClelland, umalathisi weEdinburgh and Scotland Blood Transfusion Service, xa exelela oogqirha bakhumbule ukuba “ukutofela igazi kunjengokutyanda uze ufakele ilungu lomzimba nto leyo engesiso isigqibo esilula.” Ukwacebisa ngelithi oogqirha kufuneka bacinge ngale mibuzo, “Ukuba ibindim lo ugulayo okanye ingumntwana wam, ngaba bendiya kuvuma ukuba kutofelwe igazi?”

Eneneni, iqela labezonyango livakalelwa njengesazinzulu esisebenza ngegazi esathi kubabhali bakaVukani!: “Thina bantu batofela igazi asikuthandi ukutofelwa okanye ukutofela igazi.” Ukuba le yindlela ezivakalelwa ngayo iingcungela zezonyango, bafanele bavakalelwe njani abaguli?

Ngaba Indlela Yonyango Iza Kutshintsha?

Usenokuzibuza ‘ukuba ukutofela igazi kubeka ubomi babantu esichengeni, kutheni igazi lisasetyenziswa kangaka ukuba zikho ezinye iindlela zonyango?’ Esinye isizathu sikukuba oogqirha abaninzi bayakrikriza ukutshintsha iindlela zonyango okanye abazazi ezinye iindlela zonyango zangoku ezithabathel’ indawo igazi. Ngokutsho kwenqaku elikulindixesha iTransfusion, “oogqirha benza izigqibo zokutofela igazi ngokusekelwe kwindlela abafunde ngayo, indlela izinto eziqhele ukwenziwa ngayo nakwimiphumo yokuxilonga.’”

Enye into eyenza umahluko bubuchule bogqirha owenza utyando. UGqr. Beverley Hunt waseLondon, eNgilani, ubhala athi “abantu abophi ngomlinganiselo ofanayo yaye oko kuxhomekeke kumtyandi, yaye kukho iphulo elitsha lokufundisa abatyandi iindlela ezintsha zokuthintela ukopha. Abanye balilisela ngelithi ezinye iindlela zonyango ngaphandle kokutofelwa igazi zibiza imali eninzi, phofu zona iingxelo zithetha enye into. Noko ke, oogqirha abaninzi bayavumelana nomlawuli wezonyango uGqr. Michael Rose xa esithi: “Nawuphi na umguli owenziwa utyando aze angatofelwa igazi, eneneni wenziwe olona tyando lusemagqabini.”a

Unyango olusemagqabini—ngaba asinto uyifunayo leyo? Ukuba kunjalo, kukho into ofana ngayo nabantu abakuphathele eli phephancwadi. Qhubeka ufunda ukuze uve indlela abakujonga ngayo ukutofelwa igazi.

[Umbhalo osemazantsi]

[Amagama acatshulweyo akwiphepha 6]

‘Cinga kabini ngaphambi kokuba utofele igazi emntwini.’—Unjingalwazi uIan M. Franklin

[Amagama acatshulweyo akwiphepha 6]

“Ukuba ibindim lo ugulayo okanye ingumntwana wam, ngaba bendiya kuvuma ukuba kutofelwe igazi?”—Brian McClelland

[Ibhokisi/Umfanekiso okwiphepha 7]

Ukubulawa YiTRALI

I-TRALI (Transfussion-related acute lung injury), eyaqala ukwaziwa ngowe-1990, sisifo esibulalayo esibangelwa kukungasebenzi kwenkqubo yomzimba yokuzikhusela kwizifo, esibakho emva kokutofelwa igazi. Kuthiwa esi sifo sibulala abantu abaninzi nyaka ngamnye. Phofu ke, iingcali zicinga ukuba baninzi gqitha abantu ababulawa sesi sifo ekubeni oogqirha abaninzi bengazazi iimpawu zaso. Nakuba ingaziwa into ebangela esi sifo, iNew Scientist ithi, igazi elibangela oku “libonakala ngathi lisuka kubantu abaye batofelwa igazi labantu abakumaqela egazi awahlukahlukeneyo . . . izihlandlo eziliqela.” Ngokutsho kwenye ingxelo, iTRALI ikuluhlu oluphezulu kwizifo ezibulalayo ezibangelwa lutofelo-gazi eBritani naseUnited States, oku kuyenza ibe “yingxaki inkulu kumaziko egazi ngaphezu kwezifo ezibulalayo njengeHIV.”

[Ibhokisi/Umzobo okwiphepha 8, 9]

Izinto Eziyila Igazi

Ngokuqhelekileyo abo banikela ngegazi litsalwa linjalo. Noko ke, ngamanye amaxesha banikela ngeplasma. Nakuba kwamanye amazwe lingamkelwa igazi njengokuba linjalo, kumathuba amaninzi igazi liyahlulwa lize libe ziinxalenye zalo eziphambili ngaphambi kokuba lixilongwe lize lisetyenziswe njengonyango. Khawuqwalasele inxalenye nganye kwezine, imisebenzi yazo kunye nomlinganiselo wegazi kwinxalenye nganye.

IPLASMA inomlinganiselo wegazi onokuba ngama-52 ukusa kuma-62 ekhulwini. Ilulwelo olungathi lumthubi yaye iquka iiseli zegazi, iiproteni nezinye izinto.

Iplasma inamanzi akumlinganiselo wama-91,5 ekhulwini. Iproteni efumaneka kwiplasma, isisi-7 ekhulwini (iialbulmin, zisisi-4 ekhulwini; iiglobulin zisisi-3 ekhulwini kunye nefibrinogen engaphantsi kwesi-1 ekhulwini). Inxalenye yeplasma emalunga nesi-1,5 ekhulwini iyilwe zezinye izinto ezinjengezondlo, amadlala, umoya esiwuphefumlayo, iielectrolyte, iivithamin, ukungcola okunenitrojini.

IISELI ZEGAZI EZIMHLOPHE (iileukocyte) zinomlinganiselo wegazi ongaphantsi kwesi-1 ekhulwini. Ezi seli zihlasela zize zitshabalalise izinto ezinokuba yingozi emzimbeni.

IIPLATELET (iithrombocyte) zingumlinganiselo ongaphantsi kwesi-1 ekhulwini egazini. Zona zenza amahlwili athintela inxeba lingophi.

IISELI EZIBOMVU (iierythrocyte) zingumlinganiselo onokuba ngama-38 ukusa kuma-48 ekhulwini egazini. Ezi seli zigcina izihlunu ziphila ngokuzisa ioksijini nangokuthwala ikarbon diokside ziyikhuphela ngaphandle komzimba.

Kanye njengokuba kwiplasma kunokuphuma iinxalenye ezahlukahlukeneyo, ezinye iinxalenye zegazi zinokwahlulwa zibe ziinxalenye encinane. Ngokomzekelo, ihemoglobin yinxalenye yeeseli ezibomvu.

[Umzobo]

IPLASMA

AMANZI 91.5%

IPROTENI 7%

IiALBUMIN

IIGLOBULIN

IFIBRINOGEN

EZINYE IZINTO 1.5%

IZONDLO

IHORMONES

UMOYA ESIWUPHEFUMLAYO

IIELECTROLYTE

IIVITHAMINI

UKUNGCOLA OKUNENITROJINI

[Inkcazelo]

Iphepha 9: Imifanekiso yeenxalenye zegazi ekwizangqa: Eli phulo lilonke okanye inxalenye yalo laxhaswa ngemali evela kwiNational Cancer Institute, National Institutes of Health, phantsi kwesivumelwano esingu-N01-CO-12400. Oko kubhalwe kweli phephancwadi akunanto yakwenza nezimvo okanye imigaqo yeSebe Lempilo NeeNkonzo Zoluntu kwaye akuncomeli naliphi na iyeza okanye umzi-mveliso walo okanye nawuphi na umbutho karhulumente waseUnited States

[Ibhokisi/Umfanekiso okwiphepha 8, 9]

Ezinye Iindlela Zonyango Ngaphandle Kwegazi

Kwiminyaka emithandathu edluleyo, iiKomiti Zokunxibelelana Nezibhedlele zamaNgqina kaYehova ehlabathini lonke ziye zanika abezonyango amashumi amawaka eevidiyo ezinomxholo othi Transfusion-Alternative Strategies—Simple, Safe, Effective ngeelwimi ezinokuba ngama-25.b Kule vidiyo kuboniswa oogqirha abavunyiweyo bethetha ngeendlela eziphumelelayo ezisetyenziswayo ngoku ukuze kuncedwe abantu abagulayo ngaphandle kokutofelwa kwegazi. Abantu baye basabela kweli khwelo. Ngokomzekelo, emva kokubukela le vidiyo ngasekupheleni kowama-2001, umbutho wegazi waseBritani iNational Blood Service (NBS) wathumela ileta kunye nale vidiyo kubo bonke abalathisi bamaziko egazi kulo lonke elo lizwe. Abezonyango bakuvuyela ukubukela le vidiyo ngenxa yokuba “abantu balwamkela ngakumbi unyango olusemgangathweni olungaphandle kwegazi.” Ileta yona yabonisa ukuba “umyalezo odluliselwa [kule vidiyo] uyancomeka kwaye uxhaswa ngokupheleleyo yi-NBS.”

[Umbhalo osemazantsi]

[Ibhokisi/Umfanekiso okwiphepha 9]

Ukwahlula Iinxalenye Eziphambili Zegazi—Ukusetyenziswa Kweenxalenye Ezincinane Zegazi Kwezonyango

Izazinzulu ziye zakwazi ukwahlula iinxalenye eziphambili zegazi. Ngokomzekelo: Amanzi aselwandle, ayilwe ngamanzi amalunga nama-95,5 ekhulwini, kodwa ngokwahlulwa kunokuvela ezinye izinto ezifana nemagnesium, ibromine netyuwa. Ngokufanayo ke, iplasma esegazini, eyinxalenye engaphezu kwesiqingatha egazini, ngaphezu kwama-90 ekhulwini kuyo ngamanzi yaye inokuvelisa ezinye iinxalenye ezinjengeproteni, ialbumin, ifibrinogen neeglobulin ezahlukahlukeneyo.

Njengenxalenye yonyango ugqirha unokuncomela ukuba kusetyenziswe umxube weplasma. Umzekelo woku ngumxube oneproteni eninzi, owenziwa ngokukhenkcisa iplasma ize inyibilikiswe. Inxalenye yeplasma engenakunyibilikiswa ijiya kakhulu yaye idla ngokusetyenziswa ekuthinteleni ukopha. Ezinye iindlela zonyango zisenokuquka izinto ezinenxalenye yegazi, enoba likho kancinane okanye kakhulu.c Ezinye iiprotini ezifumaneka kwiplasma zinokusetyenziswa kwizitofu ezinokwandisa amandla omzimba okuzikhusela emva kokuhlaselwa ziintsholongwane. Phantse zonke iinxalenye zegazi ezisetyenziswa ngoogqirha zineeproteni ezifumaneka kwiplasma.

Ngokutsho kweScience News, “izazinzulu zazi kuphela amakhulu ambalwa eeproteni, yaye kuqikelelwa ukuba zingamawaka iindidi zeeproteni ezifumaneka kwigazi lomntu.” Njengokuba kwixesha elizayo abantu bezuza ulwazi olungakumbi ngegazi, kusenokwenziwa amayeza amatsha angakumbi ngokusuka kwezi protini.

[Umbhalo osemazantsi]

[Umfanekiso okwiphepha 6, 7]

Abanye bezonyang bakulumkele gqitha ukuphatha igazi