Ukwelapha Ngokumpompela Igazi—Ingabe Ikusasa Lako Lilondekile?

“Ukwelapha ngokumpompela igazi kuyoqhubeka kunjengokuhamba ehlathini lemvula, lapho kunemizila ecacile eyaziwayo kodwa kusadingeka ukuba umuntu anyathel’ ebheka, futhi lapho kungenzeka khona ukuthi kusenezinsongo ezintsha futhi ezingabonakali ezingabamba abangaqaphile.”—U-Ian M. Franklin, uprofesa wokwelapha ngokumpompela igazi.

NGEMVA kokuba umshayabhuqe wengculaza wenze ukuba abantu bacusumbule indaba yegazi ngawo-1980, kwenziwa imizamo emikhulu yokuqeda ‘izinsongo zalo ezingabonakali.’ Noma kunjalo, kusenezithiyo ezinkulu. Ngo-June 2005, i-World Health Organization yavuma: “Amathuba okumpontshelwa igazi elingenazifo . . . ayahlukahluka kakhulu kuye ngamazwe.” Kungani?

Emazweni amaningi azikho izinhlelo zikazwelonke zokuqinisekisa ukuthi igazi nemikhiqizo yalo kuqoqwa, kuhlolwe, futhi kuthuthwe ngendlela ephephile. Ngezinye izikhathi igazi lize ligcinwe ngendlela eyingozi—eziqandisini zasendlini ezingasebenzi kahle nakuma-cooler box! Njengoba zingekho izindinganiso zokuphepha, abelashwayo bangaguliswa yigazi elithathwe kothile ohlala endaweni eqhele ngamakhulu noma ngezinkulungwane zamakhilomitha.

Igazi Elingenazifo—Umgomo Okunzima Ukuwufinyelela

Amanye amazwe athi umthamo wegazi ogciniwe uphephe kakhulu kunanini ngaphambili. Nokho, kusenezizathu zokuqapha. “Incwadi Yokwaziswa” eyakhishwa izinhlangano ezintathu zegazi zase-United States zihlangene ithi ekhasini layo lokuqala: “ISIXWAYISO: Ngenxa yokuthi igazi lilonke nezingxenye zalo kuvela egazini labantu, kungase kube nengozi yokudlulisela izifo, ezinjengamagciwane. . . . Ukukhetha abathekelisayo ngokucophelela nezindlela zokulihlola ezikhona akuyiqedi le ngozi.”

Yingakho uPeter Carolan, isikhulu se-International Federation of Red Cross and Red Crescent Societies ethi: “Ayikho indlela yokunikeza iziqinisekiso eziphelele uma kuziwa egazini.” Uyanezela: “Kuyohlale kunezifo ezintsha okungenandlela yokuzihlola ngaleso sikhathi.”

Kuthiwani uma kungavela isifo esisha esithathelwanayo—okuphela isikhathi eside njengengculaza singatholakali kwabanaso futhi esidluliselwa kalula ngegazi? Ekhuluma engqungqutheleni yezokwelapha ePrague, eCzech Republic, ngo-April 2005, uDkt. Harvey G. Klein we-U.S. National Institutes of Health wathi amathuba okubhekana naleso simo ayasangulukisa. Wanezela: “Abantu abaqongelela izingxenye zegazi bebengeke babe nendlela yokunqanda umshayabhuqe odluliselwa ngokumpontshelwa, njengoba kwakunjalo uma kuqala ingculaza.”

Amaphutha Nokugula Kwabantu Lapho Bempontshelwa

Yiziphi izinsongo ezinkulu ezihlobene nokumpontshelwa abagulayo ababhekene nazo emazweni asethuthukile? Amaphutha nokuphazamiseka kwamasosha omzimba. Lapho likhuluma ngocwaningo olwenziwa eCanada ngo-2001, iphephandaba i-Globe and Mail labika ukuthi izinkulungwane zabantu abampontshelwa igazi zacishe zafa ngenxa “yokuthathwa kwamasampula egazi kubantu abangafanele, ukufaka amalebula ayiphutha kuwo nokucela umuntu okungeyena ukuba kuthathwe igazi lakhe.” Amaphutha anjalo abulala okungenani abantu abangu-441 e-United States phakathi kuka-1995 no-2001.

Labo abampontshelwa igazi lomunye umuntu cishe babhekana nezingozi ezifana ncamashí nalezo zabantu abafakelwa isitho somunye umuntu. Amasosha omzimba avame ukuzenqaba izitho ezivela ngaphandle. Kwezinye izimo, ukumpontshelwa igazi kungavimbela ukusebenza kwawo la masosha omzimba. Ukucindezeleka okunjalo kwamasosha omzimba kushiya ogulayo esengozini yokuthola izifo ngemva kokuhlinzwa nokungenwa amagciwane ayengeyona ingozi ngaphambili. Yingakho uProfesa Ian M. Franklin, ocashunwe ekuqaleni kwalesi sihloko, ekhuthaza odokotela ukuba “bacabangisise ngaphambi kokumpompela iziguli ngegazi.”

Ochwepheshe Baveza Umbono Wabo

Njengoba zinalolu lwazi, izisebenzi eziningi zezokwelapha seziqala ukukubheka ngelinye iso ukwelapha ngokumpompela igazi. Incwadi ethi Dailey’s Notes on Blood iyabika: “Abanye odokotela bami kwelokuthi igazi lomunye umuntu liwumuthi oyingozi nokuthi ukulisebenzisa bekuyokwenqatshelwa ukube bekuhlaziywa njengeminye imithi.”

Ngasekupheleni kuka-2004, uProfesa Bruce Spiess washo okulandelayo ngokumpontshelwa kwengxenye yegazi eyinhloko ezigulini ezihlinzwa inhliziyo: “Kunemibiko embalwa kakhulu [yezokwelapha], uma ikhona, esekela ukuthi ukumpontshelwa empeleni kuthuthukisa imiphumela ezigulini.” Empeleni, ubhala ukuthi okuningi kwalokhu kumpontshelwa “kungalimaza kakhulu kunokuba kusize cishe kuzo zonke izimo ngaphandle kwalapho umuntu elimele,” okwandisa “ingozi yokungenwa i-pneumonia, amagciwane, ukumelwa inhliziyo nokushaywa unhlangothi.”

Abaningi bayamangala lapho bezwa ukuthi izindinganiso zokumpompela igazi azivumelani ngendlela ababelindele ngayo. UDkt. Gabriel Pedraza ukhumbuze ozakwabo muva nje eChile ukuthi “ukumpompela kuwumkhuba ongacaciswanga kahle,” owenza kube “nzima ukuba . . . kusetshenziswe iziqondiso ezifanayo emhlabeni wonke.” Yingakho uBrian McClelland, umqondisi we-Edinburgh and Scotland Blood Transfusion Service, ecela odokotela ukuba “bakhumbule ukuthi ukumpompela igazi kuwukufakela isitho, ngakho akusona isinqumo esincane.” Usikisela ukuba odokotela bazibuze lo mbuzo, “Ukube bekuyimina noma umntanami, bengiyovuma yini ukuba ampontshelwe?”

Empeleni, izisebenzi eziningi zezokwelapha zizizwa ngendlela esazizwa ngayo esinye isazi segazi, esatshela i-Phaphama!: “Thina esingochwepheshe bokwelapha ngokumpompela igazi asikuthandi ukumpontshelwa noma ukuthekelisa ngalo.” Uma abanye abantu abangochwepheshe kwezokwelapha bezizwa ngale ndlela, kufanele zizizwe kanjani iziguli?

Ingabe Ezokwelapha Ziyoshintsha?

Ungase uzibuze, ‘Uma ukwelapha ngokumpompela igazi kunezingozi eziningi kangaka, kungani igazi lisasetshenziswa kangaka, ikakhulu uma kunezinye izinto ezingase zisetshenziswe esikhundleni salo?’ Esinye isizathu siwukuthi odokotela abaningi bamane nje bamanqikanqika ukushintsha izinqubo zokwelapha noma abawazi amakhambi asetshenziswa njengamanje esikhundleni sokumpompela igazi. Ngokwesihloko esithile ephephabhukwini i-Transfusion, “odokotela benza izinqumo zokumpompela kuye ngokwalokho abakufundiswa esikhathini esidlule, ngesiko ‘nangokwahlulela kwabo ngemva kokuhlola isiguli.’”

Ikhono likadokotela ohlinzayo nalo liyawenza umahluko. UDkt. Beverley Hunt waseLondon, eNgilandi, uthi “ukopha kuyahlukahluka kuye ngodokotela abahlinzayo, futhi kunesithakazelo esikhulu sokuqeqesha odokotela abahlinzayo ngezinqubo ezifanele zokunqanda ukopha.” Abanye bathi ezinye izindlela ezingampompeli igazi zimba eqolo, nakuba sekutholakala imibiko ebonisa ukuthi akunjalo. Nokho, odokotela abaningi bangavumelana nomqondisi wezokwelapha uDkt. Michael Rose, othi: “Noma isiphi isiguli eselashwa ngaphandle kwegazi empeleni sisuke sihlinzwa ngendlela ephambili kakhulu ongase uyicabange.”a

Izinga eliphakeme lokunakekelwa kwempilo—ingabe akukhona lokho okufunayo? Uma kunjalo, kunokuthile ofana ngako nabantu abakulethele lo magazini. Sicela ukuba uqhubeke ufunda ukuze uzwe ngesinqumo sabo esiphawulekayo endabeni yokumpontshelwa igazi.

[Umbhalo waphansi]

[Amazwi acashunwe esihlokweni ekhasini 6]

‘Cabangisisani ngaphambi kokumpompela iziguli ngegazi.’—UProfesa Ian M. Franklin

[Amazwi acashunwe esihlokweni ekhasini 6]

“Ukube bekuyimina noma umntanami, bengi-yovuma yini ukuba ampontshelwe?”—UBrian McClelland

[Ibhokisi/Isithombe ekhasini 7]

Ukubulawa I-TRALI

Isifo esibi esiwohloza amaphaphu esibangelwa ukumpontshelwa igazi (transfusion-related acute lung injury [TRALI]), esaqala ukubikwa ekuqaleni kwawo-1990, siyisifo esisongela ukuphila esibangelwa ukuphazamiseka kwamasosha omzimba ngemva kokumpontshelwa igazi. Manje sekuyaziwa ukuthi i-TRALI ibulala amakhulukhulu abantu unyaka ngamunye. Nokho, ochwepheshe bacabanga ukuthi isibalo siphakeme kakhulu kunalokhu, njengoba izisebenzi eziningi zezokwelapha zingazazi izimpawu. Nakuba kungaziwa kahle ukuthi le nkinga ibangelwa yini, umagazini i-New Scientist uthi igazi elibangela lesi sifo “kubonakala sengathi livela ngokuyinhloko kubantu abaye bampontshelwa igazi elithathwe ezigabeni ezihlukahlukene esikhathini esidlule, . . . njengabantu abaye bampontshelwa igazi kaningi.” Omunye umbiko uthi i-TRALI cishe isiyimbangela eyinhloko ohlwini lwezifo ezihlobene nokumpontshelwa ezibulala abantu e-United States naseBrithani, okuyenza ibe “inkinga enkulu kunezifo ezaziwayo njenge-HIV izikhungo ezigcina igazi ezibhekene nayo.”

[Ibhokisi/Umdwebo ekhasini 8, 9]

Ukwakheka Kwegazi

Abantu abathekelisa ngegazi ngokuvamile banikela ngegazi liphelele. Nokho, ezimweni eziningi banikela nge-plasma. Nakuba amanye amazwe empompela igazi eliphelele, ngokuvamile igazi lihlukaniswa ngezingxenye zalo eziyinhloko ngaphambi kokuba lihlolwe bese lisetshenziswa ekwelapheni. Phawula izingxenye zalo ezine eziyinhloko, umsebenzi wazo kanye nomthamo wengxenye ngayinye kulo lonke igazi.

I-PLASMA yakha amaphesenti angu-52 kuya kwangu-62 alo lonke igazi. Iwuketshezi oluthi alube phuzi oluthwala amangqamuzana egazi, amaprotheni nezinye izinto.

I-plasma inamaphesenti angu-91,5 amanzi. Amaprotheni, okuthathwa kuwo izingxenyana ze-plasma, akha amaphesenti angu-7 ayo (kuhlanganise nama-albumin, akha amaphesenti angaba mane e-plasma; ama-globulin, angamaphesenti amathathu; kanye ne-fibrinogen, engaphansi kwephesenti elilodwa). Amaphesenti angu-1,5 asele e-plasma akhiwa ezinye izinto, njengezakhi, ama-hormone, amagesi asekela isimiso sokuphefumula, ama-electrolyte, amavithamini kanye nemfucumfucu ye-nitrogen.

AMANGQAMUZANA EGAZI AMHLOPHE (ama-leukocyte) akha ingxenye engaphansi kwephesenti yalo lonke igazi. Ahlasela futhi abhubhise izinto eziyingozi ezivela ngaphandle.

AMA-PLATELET (ama-thrombocyte) akha ingxenye engaphansi kwephesenti yalo lonke igazi. Enza amahlule anqanda ukopha kwezilonda.

AMANGQA-MUZANA EGAZI ABOMVU (ama-erythrocyte) akha amaphesenti aphakathi kwangu-38 nangu-48 alo lonke igazi. La mangqamuzana agcina izicubu ziphila ngokuzilethela umoya-mpilo bese ekhipha isikhutha.

Njengoba i-plasma yegazi ingaba umthombo wezingxenyana ezihlukahlukene, ezinye izingxenye eziyinhloko zingahlukaniswa zibe yizingxenyana ezincane. Ngokwesibonelo, i-hemoglobin iyingxenyana yamangqamuzana egazi abomvu.

[Umdwebo]

I-PLASMA

AMANZI 91,5%

AMAPROTHENI 7%

AMA-ALBUMIN

AMA-GLOBULIN

I-FIBRINOGEN

EZINYE IZINTO 1,5%

IZAKHI

AMA-HORMONE

AMAGESI ASIZA ISIMISO SOKUPHEFUMULA

AMA-ELECTROLYTE

AMAVITHAMINI

IMFUCUMFUCU YE-NITROGEN

[Imithombo]

Page 9: Blood components in circles: This project has been funded in whole or in part with federal funds from the National Cancer Institute, National Institutes of Health, under contract N01-CO-12400. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government

[Ibhokisi/Isithombe ekhasini 8, 9]

Ezinye Izindlela Zokwelapha Esikhundleni Sokumpompela Igazi

Kule minyaka eyisithupha edlule, amaKomiti Okubonisana Nezibhedlela oFakazi BakaJehova aye ahambisela labo abasebenza kwezokwelapha amashumi ezinkulungwane ze-video ethi Transfusion-Alternative Strategies—Simple, Safe, Effective ngezilimi ezingaba ngu-25.b Le video ibonisa odokotela abaziwa emhlabeni wonke bechaza izinqubo eziphumelelayo ezisetshenziswa njengamanje ekwelapheni iziguli ngaphandle kokuzimpompela igazi. Abantu bayazazisa lezi zinhlelo. Ngokwesibonelo, ngemva kokubuka le video ngasekupheleni kuka-2001, i-National Blood Service (NBS) e-United Kingdom yathumela incwadi kanye nale video kubo bonke abaphathi bezikhungo ezigcina igazi nezazi zegazi kulo lonke lelo zwe. Bakhuthazwa ukuba bayibuke le video ngenxa “yokuqhubeka beqaphela ukuthi enye yezinhloso zokwelapha okuhle iwukuba kugwenywe ukumpompela igazi uma kungenzeka.” Le ncwadi yavuma ukuthi “umyalezo oqukethwe [yile video] uyancomeka futhi i-NBS iwusekela ngokuqinile.”

[Umbhalo waphansi]

[Ibhokisi/Isithombe ekhasini 9]

Ukuhlukaniswa Kwegazi Ngokwezingxenye Zalo—Ukusetshenziswa Kwezi-ngxenyana Zegazi Ekwelapheni

Ngenxa yesayensi nezobuchwepheshe kunendlela yokuphawula izingxenyana ezakha igazi bese zihlukaniswa. Ngokwesibonelo: Amanzi olwandle, anamaphesenti angu-96,5 amanzi ahlanzekile, angahlukaniswa ngezingxenye ukuze kutholakale ezinye izingxenye ezikuwo, njenge-magnesium, i-bromine kanye nosawoti. Ngokufanayo, i-plasma, eyakha umthamo ongaphezu kwesigamu walo lonke igazi, yakhiwa amaphesenti angaphezu kwangu-90 amanzi futhi ingahlukaniswa ukuze kukhishwe izingxenyana ezithile kuhlanganise namaprotheni, njenge-albumin, i-fibrinogen nama-globulin ahlukahlukene.

Njengengxenye yendlela yokwelapha, udokotela angase atuse ukuba kusetshenziswe kakhulu ingxenyana ethile ye-plasma. Isibonelo salokhu i-cryoprecipitate enamaprotheni amaningi, etholakala ngokuqandisa i-plasma bese incibilikiswa kamuva. Le ngxenyana ye-plasma engancibiliki inezithako eziningi ezijiyisa igazi futhi ngokuvamile inikezwa iziguli ukuze kunqandwe ukopha. Ezinye izindlela zokwelapha zingase zihlanganise umkhiqizo onengxenye ethile yegazi, kungakhathaliseki ukuthi incane noma inkulu kuleso sithako.c Eminye imijovo esetshenziswa njalo inamaprotheni athile e-plasma asiza amasosha omzimba ngemva kokungenwa amagciwane. Cishe zonke izingxenyana zegazi ezisetshenziswa ekwelapheni zinamaprotheni atholakala kuyi-plasma yegazi.

Ngokwe-Science News, “ososayensi baye bathola amakhulu ambalwa kuphela amaprotheni phakathi kwabalelwa ezinkulungwaneni ngokuvamile atholakala egazini lomuntu.” Njengoba beya beliqonda kangcono igazi esikhathini esizayo, kungase kuvele imikhiqizo emisha eyenziwe ngala maprotheni.

[Umbhalo waphansi]

[Isithombe ekhasini 6, 7]

Ezinye izisebenzi zezokwelapha ziyacophelela ukuze zingalithinti igazi