{"id":2849,"date":"2019-08-18T12:00:13","date_gmt":"2019-08-18T09:00:13","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=2849"},"modified":"2019-08-18T10:33:28","modified_gmt":"2019-08-18T07:33:28","slug":"organ-transplantasyonuna-yeni-bir-yaklasim-hucre-terapisi","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/organ-transplantasyonuna-yeni-bir-yaklasim-hucre-terapisi\/","title":{"rendered":"Organ Transplantasyonuna Yeni Bir Yakla\u015f\u0131m: H\u00fccre Terapisi"},"content":{"rendered":"\n

Organ yetmezli\u011finin son safhas\u0131nda olan pek \u00e7ok hasta i\u00e7in nakil en etkili tedavi se\u00e7ene\u011fi haline gelir. G\u00fcn\u00fcm\u00fczde kullan\u0131lmakta olan ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131lar etkili bir \u015fekilde akut reddi \u00f6nleyebiliyor fakat y\u00fcksek morbidite oran\u0131 ve kronik reddin \u00f6nlenmesindeki etkilerinin azl\u0131\u011f\u0131 hala bu bask\u0131lay\u0131c\u0131lar\u0131n ciddi problemleri olarak g\u00f6r\u00fcl\u00fcyor. D\u00fczenli olarak ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131 kullanmak zorunda olan organ al\u0131c\u0131lar\u0131 bu tarz problemlerle m\u00fccadele etmeye devam ediyor ve bu problemler onlar\u0131n sa\u011f kal\u0131mlar\u0131n\u0131 etkiliyor. \u015eansl\u0131y\u0131z ki son yap\u0131lan \u00e7al\u0131\u015fmalar \u0131\u015f\u0131\u011f\u0131nda v\u00fccudu farkl\u0131 bir don\u00f6rden gelecek yeni bir organa haz\u0131rlamak m\u00fcmk\u00fcn olabilir ve gelecekte organ nakli ger\u00e7ekle\u015fmi\u015f insanlar\u0131n ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131lara ihtiyac\u0131 kalmayabilir.<\/em><\/strong><\/p>\n\n\n\n

\"\"
Organ transplantasyonu ger\u00e7ekle\u015ftiren cerrahi ekip<\/strong><\/em>
Kaynak:<\/strong><\/em> https:\/\/cdn.cnn.com\/cnnnext\/dam\/assets\/180214115440-organ-transplant-surgery-file-super-tease.jpg<\/a> <\/figcaption><\/figure>\n\n\n\n

Yeni y\u00f6ntem don\u00f6r\u00fcn h\u00fccrelerinin operasyondan bir hafta \u00f6nce al\u0131c\u0131ya verilmesini i\u00e7eriyor. Bu da y\u00f6ntemin b\u00f6brek, karaci\u011fer ve pankreas gibi canl\u0131 don\u00f6rden elde edilebilen organlar i\u00e7in ge\u00e7erli olabilece\u011fi anlam\u0131na geliyor. Teknik be\u015f adet makak maymunu (Macaca mulatta)<\/em> \u00fczerinde test edildi\u011finde nakledilen pankreas h\u00fccreleri reddedilmeden sa\u011fl\u0131kl\u0131 bir \u015fekilde iki y\u0131l kalmay\u0131 ba\u015fard\u0131.<\/p>\n\n\n\n

B\u00f6brek, karaci\u011fer ve kalp gibi organlar al\u0131c\u0131 i\u00e7in hayat kurtar\u0131c\u0131 olmakla birlikte, nakledildi\u011fi andan itibaren ki\u015finin \u00f6mr\u00fc boyunca ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131 ila\u00e7lar kullanmas\u0131n\u0131, b\u00f6ylelikle yeni organ\u0131n reddedilmesinin \u00f6nlenmesini gerektiriyor. Kullan\u0131lan bu ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131 ila\u00e7lar\u0131n enfeksiyonlara yatk\u0131nl\u0131k ve kanser gibi ciddi yan etkileri var. Dolay\u0131s\u0131yla bilim insanlar\u0131 y\u0131llard\u0131r ba\u011f\u0131\u015f\u0131kl\u0131k sistemini bask\u0131lamadan ger\u00e7ekle\u015ftirilebilecek bir organ naklinin yollar\u0131 ar\u0131yor.
<\/p>\n\n\n\n

Hat\u0131rlayan H\u00fccreler<\/strong><\/h2>\n\n\n\n

Minnesota \u00dcniversitesi\u2019nden Bernhard Hering ve meslekta\u015flar\u0131 ba\u011f\u0131\u015f\u0131kl\u0131k sistemimizi kendi h\u00fccrelerimize sald\u0131rmayacak \u015fekilde e\u011fitmenin bir yolunu buldular. Ya\u015famlar\u0131m\u0131z boyunca h\u00fccrelerimiz apopitoz denilen do\u011fal bir s\u00fcre\u00e7le \u00f6l\u00fcrler ve kan dola\u015f\u0131m\u0131na d\u00f6k\u00fcl\u00fcrler. Dalaktaki ba\u011f\u0131\u015f\u0131kl\u0131k h\u00fccreleri bu \u00f6lmekte olan h\u00fccreleri al\u0131r, i\u00e7erdikleri molek\u00fclleri hat\u0131rlar ve onlar\u0131 v\u00fccudun kendi h\u00fccreleri olarak i\u015faretleyerek (mikroplarca istila edilmi\u015f olanlar hari\u00e7) onlara tolerans g\u00f6sterir. Bu s\u00fcreci ECDI [1-Ethyl-3-(3-dimethylaminopropyl) carbodiimide]<\/em>\u00a0 olarak bilinen kimyasal bir madde ile h\u00fccrelerde apopitozu tetikleyerek taklit etmek m\u00fcmk\u00fcn.<\/p>\n\n\n\n

Hering\u2019in ekibi be\u015f makak maymununun pankreas\u0131ndaki ins\u00fclin \u00fcreten h\u00fccrelerini (\u03b2-h\u00fccreleri)<\/em> \u00f6ld\u00fcrmek i\u00e7in Tip 1 diyabet benzeri bir durumu tetiklediler. Ard\u0131ndan hasta maymunlar\u0131 don\u00f6r maymunlardan naklettikleri pankreas h\u00fccreleri ile tedavi ettiler.<\/p>\n\n\n\n

Ekip, uzun vadede ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131 ila\u00e7lar\u0131n kullan\u0131m\u0131ndan ka\u00e7\u0131n\u0131labilece\u011fini g\u00f6zlemlemek i\u00e7in hasta maymunlara nakilden bir hafta \u00f6nce ve bir g\u00fcn sonra olmak \u00fczere don\u00f6rlerin ECDI uygulanm\u0131\u015f kan h\u00fccrelerini verdi. Ayr\u0131ca maymunlara \u00fc\u00e7 hafta boyunca ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131 ila\u00e7lar da uyguland\u0131.
<\/p>\n\n\n\n

Ba\u015far\u0131l\u0131 Nakil<\/strong><\/h2>\n\n\n\n

Ara\u015ft\u0131rmac\u0131lar, ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131 ila\u00e7lar\u0131 vermeyi kesti\u011finde bile nakledilen pankreas h\u00fccreleri bir denekte iki di\u011ferlerinde bir y\u0131l olmak \u00fczere sa\u011fl\u0131kl\u0131 ve ins\u00fclin \u00fcretmeye devam eder bir \u015fekilde kalmay\u0131 ba\u015fard\u0131.<\/p>\n\n\n\n

Doku ba\u011f\u0131\u015f\u0131n\u0131n bu \u00f6zel formu \u00f6zellikle \u00e7ok nadir bir \u015fekilde tedavi edilebilen Tip 1 diyabete sahip ki\u015filer i\u00e7in bir umut \u00e7\u00fcnk\u00fc bu hastalar\u0131n \u00f6m\u00fcrleri boyunca ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131 ila\u00e7lara ihtiyac\u0131 var. G\u00fcn\u00fcm\u00fczde Tip 1 diyabete sahip hastalar\u0131n \u00e7o\u011fu hala ins\u00fclin enjeksiyon tedavisini tercih ediyor.  <\/p>\n\n\n\n

Hering\u2019e g\u00f6re bu yakla\u015f\u0131m canl\u0131 don\u00f6rden b\u00f6brek nakli olacak insanlar taraf\u0131ndan da kullan\u0131labilir. Birle\u015fik Krall\u0131k\u2019ta b\u00f6brek nakillerinin \u00fc\u00e7te biri canl\u0131 don\u00f6rlerden ger\u00e7ekle\u015fiyor ki bu genellikle bir akraba veya yak\u0131n arkada\u015f oluyor fakat bazen tamamen yabanc\u0131 biri olmas\u0131 da m\u00fcmk\u00fcn.
<\/p>\n\n\n\n

\"\"
T\u00fcrkiye’de Milyon Ki\u015fi Ba\u015f\u0131na D\u00fc\u015fen Organ Nakli, 2002-2013<\/strong><\/em>
Kaynak:<\/strong><\/em> http:\/\/tonv.org.tr\/admin\/pages\/files\/TURKEY-2002-2013-ORGAN-DONATION-AND-TRANSPLANTATION-STATISTICS.pdf<\/a> <\/figcaption><\/figure>\n\n\n\n

\u00dclkemizde ve d\u00fcnyada organ nakli bekleyen ki\u015fi say\u0131s\u0131 her ge\u00e7en saat daha da artmakta. Amerika Birle\u015fik Devletleri\u2019nde her 10 <\/strong>dakikada yeni biri ulusal bekleme listesine giriyor ve her g\u00fcn organ nakli bekleyen 20 <\/strong>ki\u015fi hayat\u0131n\u0131 kaybediyor, T\u00fcrkiye\u2019de ise g\u00fcncel olarak 28272 <\/strong>hasta organ nakli bekliyor. \u00d6zellikle \u00fclkemizde canl\u0131 ve kadaverik don\u00f6r oran\u0131 istenilenin \u00e7ok alt\u0131nda. 2013 y\u0131l\u0131 verilerine g\u00f6re hastane ortam\u0131nda beyin \u00f6l\u00fcm\u00fc ger\u00e7ekle\u015fmi\u015f 1703 <\/strong>hastan\u0131n sadece %22<\/strong>\u2019sinin aileleri hastan\u0131n organlar\u0131n\u0131n kullan\u0131lmas\u0131na onay verdi.
<\/p>\n\n\n\n

Hen\u00fcz daha \u00e7ok erken a\u015famalar\u0131nda olan bu yeni y\u00f6ntem sayesinde gelecekte organ ve doku reddini minimuma indirebilir ve bunu yaparken hastalar\u0131n \u00f6m\u00fcr boyu ba\u011f\u0131\u015f\u0131kl\u0131k bask\u0131lay\u0131c\u0131 ila\u00e7lar kullanma mecburiyetini ortadan kald\u0131rabiliriz. B\u00f6ylelikle hem organ nakli bekleme s\u00fcresini k\u0131saltabilir hem de organ nakli ger\u00e7ekle\u015ftirilen insanlar\u0131n ya\u015fam kalitesini y\u00fckseltebiliriz.
<\/p>\n\n\n\n

Kaynak\u00e7a:<\/h2>\n\n\n\n
  1. https:\/\/www.newscientist.com\/article\/2212308-cell-injections-could-train-the-body-to-accept-a-transplanted-organ\/<\/strong><\/a><\/li>
  2. https:\/\/doi.org\/10.1038\/s41467-019-11338-y<\/strong><\/a><\/li>
  3. https:\/\/www.organdonor.gov\/statistics-stories\/statistics.html<\/strong><\/a><\/li>
  4. http:\/\/www.tonv.org.tr\/tr\/organ-bagisi\/istatistikler\/<\/strong><\/a><\/li><\/ol>\n\n\n\n

    <\/p>\n","protected":false},"excerpt":{"rendered":"

    Organ yetmezli\u011finin son safhas\u0131nda olan pek \u00e7ok hasta i\u00e7in nakil en etkili tedavi se\u00e7ene\u011fi haline gelir. G\u00fcn\u00fcm\u00fczde kullan\u0131lmakta olan ba\u011f\u0131\u015f\u0131kl\u0131k<\/p>\n","protected":false},"author":153,"featured_media":2851,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1,25,19,165],"tags":[387,392,388,394,390,393,389,395,391,386],"acf":[],"views":1630,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/2849"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/153"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=2849"}],"version-history":[{"count":7,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/2849\/revisions"}],"predecessor-version":[{"id":2860,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/2849\/revisions\/2860"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/2851"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=2849"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=2849"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=2849"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}