{"id":17559,"date":"2014-09-18T09:36:02","date_gmt":"2014-09-18T07:36:02","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=17559"},"modified":"2014-09-18T09:48:06","modified_gmt":"2014-09-18T07:48:06","slug":"prvni-pacient-jenz-po-transplantaci-jater-uz-nemusi-brat-imunosupresiva","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=17559","title":{"rendered":"Prvn\u00ed pacient, jen\u017e po transplantaci jater u\u017e nemus\u00ed br\u00e1t imunosupresiva"},"content":{"rendered":"<p><strong>V pra\u017esk\u00e9m IKEM provedli poprv\u00e9 v \u010cesku operaci, p\u0159i n\u00ed\u017e pacientovi s akutn\u00edm selh\u00e1n\u00edm jater odstranili jen p\u016flku tohoto org\u00e1nu a m\u00edsto n\u00ed mu transplantovali lalok jater od zem\u0159el\u00e9ho d\u00e1rce. Celosv\u011btov\u011b ojedin\u011bl\u00e1 operace mu\u017ee, kter\u00e9mu zb\u00fdvalo jen n\u011bkolik dn\u00ed \u017eivota, zachr\u00e1nila.<\/strong> <!--more--><\/p>\n<p>Nav\u00edc pacient nebude muset br\u00e1t a\u017e do konce \u017eivota l\u00e9ky na potla\u010den\u00ed imunity jako p\u0159i \u00fapln\u00e9 transplantaci, sd\u011blila mluv\u010d\u00ed institutu Veronika Velcov\u00e1.<\/p>\n<p>P\u011btat\u0159icetilet\u00e9mu mu\u017ei za\u010dala selh\u00e1vat j\u00e1tra po p\u0159ed\u00e1vkov\u00e1n\u00ed paracetamolem. Podle Velcov\u00e9 si mu\u017e vzal nadm\u011brnou d\u00e1vku, kdy\u017e se cht\u011bl rychle vyl\u00e9\u010dit z vir\u00f3zy, aby nep\u0159i\u0161el o pr\u00e1ci. Otrava paracetamolem je jedna z nej\u010dast\u011bj\u0161\u00edch p\u0159\u00ed\u010din akutn\u00edho jatern\u00edho selh\u00e1n\u00ed a bez rychl\u00e9 transplantace pacient do n\u011bkolika dn\u016f um\u00edr\u00e1. Zm\u00edn\u011bn\u00fd p\u0159\u00edpad byl nav\u00edc komplikov\u00e1n t\u00edm, \u017ee jedin\u00e1 j\u00e1tra, kter\u00e1 byla v dan\u00e9 dob\u011b k dispozici pro transplantaci, nebyla z n\u011bkolika d\u016fvod\u016f vhodn\u00e1, uvedla mluv\u010d\u00ed.<\/p>\n<p>L\u00e9ka\u0159i IKEM tedy p\u0159istoupili k takzvan\u00e9 auxili\u00e1rn\u00ed transplantaci, kdy se odstran\u00ed \u010d\u00e1st pacientov\u00fdch jater, a zbytek se spoj\u00ed s \u010d\u00e1st\u00ed od d\u00e1rce. &#8222;Transplantovan\u00fd kus pom\u016f\u017ee vlastn\u00ed \u010d\u00e1sti jater k uzdraven\u00ed. To m\u00e1 pro pacienta z\u00e1sadn\u00ed v\u00fdznam &#8211; nebude muset do konce \u017eivota u\u017e\u00edvat imunosupresiva. Pokud p\u016fjde v\u0161e dob\u0159e, m\u016f\u017eeme mu za\u010d\u00edt zhruba po p\u016fl roce sni\u017eovat d\u00e1vky,&#8220; sd\u011blil p\u0159ednosta kliniky transplanta\u010dn\u00ed chirurgie Ji\u0159\u00ed Fron\u011bk, kter\u00fd z\u00e1krok provedl. &#8222;Auxili\u00e1rn\u00ed transplantace byly celosv\u011btov\u011b provedeny dosud jen v n\u011bkolika centrech. V \u010cesku ani na v\u00fdchod od n\u00e1s takov\u00fd z\u00e1krok je\u0161t\u011b nikdo neud\u011blal,&#8220; doplnil.<\/p>\n<p>U\u017e tak technicky n\u00e1ro\u010dnou operaci zt\u00ed\u017eilo l\u00e9ka\u0159\u016fm to, \u017ee na rozd\u00edl od v\u011bt\u0161iny auxili\u00e1rn\u00edch transplantac\u00ed spojovali vlastn\u00ed prav\u00fd lalok jater s darovan\u00fdm lev\u00fdm, co\u017e je podle Fro\u0148ka extr\u00e9mn\u011b slo\u017eit\u00e9. Nav\u00edc je\u0161t\u011b p\u0159ed z\u00e1krokem museli otr\u00e1ven\u00e9mu kv\u016fli rozd\u00edln\u00fdm krevn\u00edm skupin\u00e1m s org\u00e1nem od d\u00e1rce t\u0159ikr\u00e1t vym\u011bnit krevn\u00ed plazmu, aby se zbavili protil\u00e1tek. &#8222;Jinak by t\u011blo org\u00e1n v\u016fbec nep\u0159ijalo,&#8220; uvedl Fron\u011bk. Samotn\u00e1 operace pak trvala p\u0159es 11 hodin.<\/p>\n<p>Nyn\u00ed, t\u00e9m\u011b\u0159 dva t\u00fddny po z\u00e1kroku, je stav pacienta podle IKEM stabilizovan\u00fd.&#8220;J\u00e1tra funguj\u00ed v\u00fdborn\u011b a pacient postupn\u011b nab\u00edr\u00e1 s\u00edly. Nem\u00e1 ale ani zdaleka vyhr\u00e1no. Asi nejv\u00edc jsou tito pacienti ohro\u017eeni infekc\u00ed, ta se m\u016f\u017ee objevit kdykoliv. I proto zat\u00edm v Institutu klinick\u00e9 a experiment\u00e1ln\u00ed medic\u00edny z\u016fst\u00e1v\u00e1,&#8220; ozn\u00e1mila p\u0159ednostka kliniky anesteziologie, resuscitace a intenzivn\u00ed p\u00e9\u010de Eva Kieslichov\u00e1.<\/p>\n<p>Nejde o prvn\u00ed ojedin\u011bl\u00fd z\u00e1krok proveden\u00fd v IKEM. &#8222;Vzpome\u0148me nap\u0159\u00edklad lo\u0148skou z\u00e1chranu dvou dosp\u011bl\u00fdch po akutn\u00ed otrav\u011b houbami. Zde se poda\u0159ilo poprv\u00e9 rozd\u011blit jedna j\u00e1tra mezi dva dosp\u011bl\u00e9 a t\u00edm je zachr\u00e1nit. Nebo rozd\u011blen\u00ed jedn\u011bch jater mezi dva chlapce z leto\u0161n\u00edho jara,&#8220; uvedl \u0159editel institutu Ale\u0161 Herman.<\/p>\n<p>ilustra\u010dn\u00ed foto: Adam-Ciesielski-sxc.hu<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>V pra\u017esk\u00e9m IKEM provedli poprv\u00e9 v \u010cesku operaci, p\u0159i n\u00ed\u017e pacientovi s akutn\u00edm selh\u00e1n\u00edm jater odstranili jen p\u016flku tohoto org\u00e1nu a m\u00edsto n\u00ed mu transplantovali <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=17559\" title=\"Prvn\u00ed pacient, jen\u017e po transplantaci jater u\u017e nemus\u00ed br\u00e1t imunosupresiva\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14511,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-17559","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/17559","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=17559"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/17559\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14511"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=17559"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=17559"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=17559"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}