Transplantasi paranakan

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Transplantasi paranakan adalah prosedur badah rahatan paranakan nang bigas ditransplantasiakan ka dalam urganisme nang paranakannya kadaada atawa bapanyakit. Sabagai bagian matan reproduksi seksual mamalia nang nurmal, paranakan nang garing atawa kada mungkin implantasi embrio nang nurmal, nang mampan jadi maulah kada subur bini. Kajadian ngini dipinandui sabagai faktor uterus absolut infertilitas (AUFI). Transplantasi paranakan marupakan tatamba nang kawa dijadiakan pilihan gasan bantuk infertilitas ngini.

Sajarah[babak | babak asal-mulanya]

Studi[babak | babak asal-mulanya]

Rahatan 1896, Emil Knauer saikung urang Austria baumur 29 tahun nang bagawi di sabuting klinik ginekologi Wina, manarbitakan studi panambaian kisah autotransplantasi ovarium nang mandukumintasiakan fungsi nurmal di kalinci. Ihwal ngini nang maulah panalitian kisah transplantasi paranakan rahatan tahun 1918.[1][2] Rahatan tahun 1964 wan 1966, Eraslan, Hamernik wan Hardy, di Pusat Medis Universitas Mississippi di Jackson, Mississippi, adalah urang nang pamulaan manggawi autotransplantasi paranakan di satua Hadupan nang imbahnya baranak matan paranakan tadi.[3] Rahatan tahun 2010, Diaz-Garcia wan kawan bagawinya di Departemen Obstetri wan Ginekologi Universitas Gothenburg di Swedia, manampaiakan kaya apa transplantasi paranakan alogenik panambaian nang bahasi di dunia di saikung tikus nang imbahnya baisi katurunan nang bigas.[4] Rahatan tahun 2023, labih pada 100 transplantasi paranakan hudah digaw wan sabanyak 50 bayi hudah diranakakan matan samunyaan dunia.[5][6]

Kasus-kasus panting[babak | babak asal-mulanya]

Jirman[babak | babak asal-mulanya]

Kamungkinan lain di kasus nang jarang ada, saikung urang bakalamin dua wan bibinian transgender nang diranakakan lawan kalamin lalakian biar inya operasi mangganti kalamin nang kawa maulah puki sakira kawa jadi bibinian, pilihan gasan baisi paranakan kadada gasan buhannya. Artinya buhannya kada kawa batianan wan parlu maambil jalan lain sakira kawa jadi kuitan, bisa mamakai cara tradisiunal nang kaya basakian atawa cara alternatif nang kaya maangkat anak, manyumbang sel intalu, atawa pambawa batianan. Biar nang kaya ngitu, ada sabuting kasus transplantasi paranakan gasan saikung binian transgender nang digawi ulih seniman Denmark Lili Elbe (1882–1931). [7] Inya manggawi ngini lawan harapan kawa baisi anak lawan gandaknya, inya manggawi operasi transplantasi paranakan ngini rahatan 1931 baimbaian lawan vaginoplasty di Jirman pas baumur 48 tahun. Tagal imbah operasi nang digawinya tadi, inya timbul takana infeksi imbah operasi wan mati maraga gagal jantung talu bulan imbahnya.[8]

Arab Saudi[babak | babak asal-mulanya]

Cacubaan modern panambaian gasan transplantasi paranakan cungul rahatan tahun 2000 di Arab Saudi.[9] Wafa Fageeh[9] mantranplantasi paranakan matan pasien baumur 46 tahun kapasien baumur 26 tahun nang paranakannya rusak maraga pandarahan imbah baranak.[10] Maraga pasien ngini paampihannya parlu banar maangkat paranakannya matan 99 hari. Tagal inya kana nekrosis, lalu balum ada kasapakatan amun operasi ngini kawa disambat sukses atawa kada, biar paranakannya tatap bafungsi sapalihan waktu wan inya masih kawa haid dua kali. [9] Angguta komunitas medis banyak nang baganangan lawan etika prosedur ngini.[11]

Turki[babak | babak asal-mulanya]

Transplantasi paranakan nang maumpatakan pandunur nang hudah mati cungul di Turki pas 9 Agustus 2011; operasi ngini digawi ulih Ömer Özkan wan Munire Erman Akar di Rumah Sakit Universitas Akdeniz di Antalya gasan pasien baumur 21 tahun bangaran Derya Sert nang pas diranakakan kada baisi paranakan.[12][13][14][15][16][17] Amun kasus nang ngini, pasien mandapat hasil bagus nang lawas imbah operasi transplantasi paranakan ngini tarasaii haid wan imbah dua tahun inya kawa batianan.[18][19][20] Rahatan batianan, sert malewati aborsi pas talu bulan batianan imbah mantrinya kada kawa mandangar [[pakambangan jantung]|bunyi jantung]], tagal ngini komplikasi nang biasa haja wan kadada kaitannya lawan transplantasi.[21] Imbah batianan pulang maraga fertilisasi in vitro lawan batianan nang imbahnyaFollowing another pregnancy that was initiated with in vitro fertilisation wan imbah ditahani parak 28 minggu, pasien paampihannya kawa maranakakan bayinya pas tanggal 4 Juni 2020.[22]

Swedia[babak | babak asal-mulanya]

Pas 2012 di Swedia, transplantasi paranakan panambaian matan uma ka anaknya tajadi.[23] Transplantasi ngini digawi ulih Mantri Swedia matan Rumah Skit Universitas Sahlgrenska di Universitas Gothenburg dikatuai ulih Mats Brännström.[23][24][25]

Pas Uktubur 2014, dihabari amun ngini bayi nang bigas pamulaan nang diranakakan matan panarima transplantasi paranakan di dairah nang rahasiakan di Swedia. Jurnal medis Inggris The Lancet mahabarakan bayi lalakian tadi diranakakan di bulan Siptimbir, baratnya 1.8 kg (3.9 lb) wan abahnya manyambat anaknya "liwar bigasnya". Bayi tadi diranakakan sacara prematur rahatan hudah 32 minggu lawan Uparasi Sisar, imbah umanya bamula kaya takana pre-eklampsia. Uma matan bayi tranplantasi paranakan ngini baumur 36 tahun, manarima paranakan ngini pas tahun 2013 matan pandunur baumur 61 tahun, di operasi nang di kapalai ulih Brännström nang marupakan profesor Obstetri wan Ginekologi di Universitas Gothenburg.[26][27] Binian tadi baisi ovarium nang bigas tagal diranakakan kada baisi paranakan, kaadaan nang mampangaruhi saikung matan 4.500 binian. Prosedurnya mamakai embrio matan laboratorium, diulah matan ovum binian ngini lawan mani lakinya, nang imbahnya di rasukakan kadalam paranakan nang ditransplasikan tadi. Paranakannya bisa haja hudah rusak maraga uparasi sisar wan bisa haja kada kawa lagi amun batianan pulang nang kainanya. The procedure used an embryo from a laboratory, created using the woman's ovum and her husband's sperm, which was then implanted into the transplanted uterus. The uterus may have been damaged in the course of the caesarian delivery and it may or may not be suitable for future pregnancies. Tiga lapis rejimen A regimen of triple imunosupresi dipakai lawan takrolimus, azatioprin, and Kortikosteroid. Talu rundutan panulak nang lamah cungul, sakali rahatan batianan, tagal barataan kawa haja ditatambai lawan tatamba. Sapalihan binian dihabarakan jua batianan rahatan tuh imbah transplantasi paranakan.[28]

Amerika Sarikat[babak | babak asal-mulanya]

Transplantasi paranakan nang panambaian ada di Amerika Sarikat cungul pas 24 Pibruari 2016 di Klinik Cleveland.[29] Kalumpuk ngini dikapalai ulih Dr Andreas Tzakis. Transplantasi gagal maraga kumplikasi nang dirahasiaakan pas 8 Maret wan paranakannya tadi umpat dipindah jua.[30] Rahatan April, buhannya bapadah kandidiasis hudah manyabar ka sabuting arteri nang mangganii maalirakan darah ka paranakan nang ditransplansiakan, ihwal ngini imbahnya marusak artiri wan maulah darah bagumpal.[31]

Rahatan November 2017, hudah diranakakan bayi nang panambaian matan transplantasi paranakan di Amerika Sarikat.[32] Bayi ngini diranakakan di Pusta Medis Universitas Baylor di Dallas, Texas, ulih Drs Liza Johannesson wan Giuliano Testa, imbah sabuting donasi paranakan matan pandunur hidup nang kada taarah.[33] Bayi nang diranakakan matan donor transplantasi paranakan nang hudah maninggal cungul di klinik Cleveland pas bulan Juni 2019.[34]

Deskripsi[babak | babak asal-mulanya]

Prosedur[babak | babak asal-mulanya]

Transplantasi paranakan dimulai awan uparasi maangkat paranakan pandunur. Cara manggawi ngini ada gasan satua, tamasuk primata wan nang tahanyar nih manusia.[35][36][37][38][39][40] Paranakan nang hudah diangkat tadi imbah ngitu disimpan, misalnya gasan diantar ka andak urang nang manarima. The recovered uterus may need to be stored, for example for transportation to the location of the recipient. Studi kisah iskemia reperfusi dingin manampaiakan amun katahanan iskemia kawa labih pada 24 jam.[36]

Panarima kamungkinan parlu maliwati talu uparasi ganal. Pamulaan, inya parlu uparasi transplantasi. Amun kawa batianan sampai handak baranak, inya parlu uparasi sisar. Imbah panarima digaduh pakai terapi imunosupresi, habis tu imbah tuntung baranak histerektomi parlu digawi sakira terapi imunosupresi tadi kawa diampihakan.

Adab[babak | babak asal-mulanya]

Kriteria Montreal[babak | babak asal-mulanya]

Lain pada haraganya, transplantasi paranakan malibatakan adab medis nang ngalih. Prinsip Utunumi mangganii kagiatan ngini, sadangkan prinsip Nang pamulaan, kada manyakiti balawan duwa transplantasi paranakan. Amunnya prinsip bamanfaat wan adil malihat kagiatan ngini rarawaian.[11] Sakira barataan prinsip tadi baakuran "Syarat Montreal gasan transplantasi paranakan nang baik wan baadab" dikambangakan di Universitas Mcgill wan ditarbitakan di Transplant International pas 2012.[11] Kriteria montreal marupakan sagarumbung syarat nang diparluakan amun handak manggawi transplantasi paranakan gasan manusia. Syarat ngini ditampaiakan pas acara Kongres ka-20 Federasi Internasional Ginekologi wan Kabidanan di Roma rahatan Uktubur 2012.[41] Pas 2013, "Syarat Montreal gasan transplantasi paranakan nang baik wan baadab" nang hudah dihanyari ditarbitakan di Fertility and Sterility wan hudah disaranakan gasan jadi standar internasiunal gasan manggawi transplantasi paranakan nang baik wan baadab.[42]

Syarat gasan kundisi panarima, pandunur, wan buhan nang manggaduh bigasbuhannya isinya:

  1. Panarima marupakan binian asli, nang kawa manantuakan pilihan, nang kada baisi kontradiksi medis gasan transplantasi, baisi panyakit diparanakan nang kada disambuhakan lawan terapi wan baisi "kontradiksi sorang atau legal" gasan pilihan lain nang kaya uma gaganti atawa maangkat anak. Panarima parlu dipastiakan kawa jadi kuitan, kawa sacara psikologis ditiring wan panilaian, maasi haja lawan tim medis nang kaina manggaduhnya, wan paham risiku transplantasi tadi. Pas 2021, Syarat Montreal nang hudah dibaiki ditarbitakan di Bioethics duwa rancangan nang baadab gasan urang nang baisi gen XY sakira kawa dapat transplantasi paranakan.[43]
  2. The donor is a female of reproductive age with no contraindication to the procedure who has concluded her childbearing or consented donating her uterus after her death. There is no coercion and the donor is responsible and capable of making informed decisions.
  3. The health care team belongs to an institution that meets Moore's third criterion[44] regarding institutional stability and has provided informed consent to both parties. There is no conflict of interests, and anonymity can be protected unless recipient or donor waive this right.

Jujuhatan[babak | babak asal-mulanya]

  1. ^ Knauer, Emil (1896). "Einige Versuche über Ovarientransplantation bei Kaninchen" [An attempt at ovary transplantation in rabbits]. Zentralblatt für Gynäkologie (dalam bahasa Jerman). 20: 524–8. 
  2. ^ Nugent, D.; Meirow, D.; Brook, P. F.; Aubard, Y.; Gosden, R. G. (1997). "Transplantation in reproductive medicine: Previous experience, present knowledge and future prospects". Human Reproduction Update. 3 (3): 267–80. doi:10.1093/humupd/3.3.267 alt=Dapat diakses gratis. PMID 9322102. 
  3. ^ Eraslan, S.; Hamernik, R. J.; Hardy, J. D. (1966). "Replantation of uterus and ovaries in dogs, with successful pregnancy". Archives of Surgery. 92 (1): 9–12. doi:10.1001/archsurg.1966.01320190011002. PMID 5948103. 
  4. ^ Díaz-García, César; Akhi, Shamima N.; Wallin, Ann; Pellicer, Antonio; Brännström, Mats (2010). "First report on fertility after allogeneic uterus transplantation". Acta Obstetricia et Gynecologica Scandinavica. 89 (11): 1491–1494. doi:10.3109/00016349.2010.520688 alt=Dapat diakses gratis. PMID 20879912. 
  5. ^ Brännström, Mats; Racowsky, Catherine; Richards, Elliott G.; Flyckt, Rebecca; Stillman, Robert J.; O’Brien, Jeanne E.; Ryan, Ginny L.; de Ziegler, Dominique (June 2023). "Absolute uterine infertility a cornelian dilemma: uterine transplantation or surrogacy?". Fertility and Sterility (dalam bahasa Inggris). 119 (6): 918–929. doi:10.1016/j.fertnstert.2023.04.005 alt=Dapat diakses gratis. PMID 37037300 Periksa nilai |pmid= (bantuan). 
  6. ^ "Woman receives sister's womb in first UK transplant". BBC News (dalam bahasa Inggris). 2023-08-22. Diakses tanggal 2023-08-27. 
  7. ^ Kroløkke, C.; Petersen, T.S.; Herrmann, J.R.; Bach, A.S.; Adrian, S.W.; Klingenberg, R.; Petersen, M.N. (2019). The Cryopolitics of Reproduction on Ice: A New Scandinavian Ice Age. Emerald Studies in Reproduction, Culture and Society. Emerald Publishing Limited. hlm. 154. ISBN 978-1-83867-044-3. Diakses tanggal 2023-02-22. 
  8. ^ "Lili Elbe". Biography (dalam bahasa Inggris). Diakses tanggal 2019-02-25. 
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  21. ^ Derya Sert'in gebeliği sonlandırıldı. CNNTurk.com. Citakan:In lang
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  23. ^ a b Brännström, Mats; Johannesson, Liza; Dahm-Kähler, Pernilla; Enskog, Anders; Mölne, Johan; Kvarnström, Niclas; Diaz-Garcia, Cesar; Hanafy, Ash; Lundmark, Cecilia; Marcickiewicz, Janusz; Gäbel, Markus; Groth, Klaus; Akouri, Randa; Eklind, Saskia; Holgersson, Jan; Tzakis, Andreas; Olausson, Michael (2014). "First clinical uterus transplantation trial: a six-month report". Fertility and Sterility. 101 (5): 1228–1236. doi:10.1016/j.fertnstert.2014.02.024 alt=Dapat diakses gratis. PMID 24582522. 
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  30. ^ Zeltner, Brie (2016-03-09). "Nation's first uterus transplant, performed at the Cleveland Clinic, fails". The Plain Dealer. Diakses tanggal 2016-03-10. 
  31. ^ Denise Grady (April 8, 2016). "Yeast Infection Led to Removal of Transplanted Uterus". The New York Times. Diakses tanggal April 8, 2016. 
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  34. ^ Flyckt, R.; Falcone, T.; Quintini, C.; et al. (August 2020), "First birth from a deceased donor uterus in the United States: from severe graft rejection to successful cesarean delivery", American Journal of Obstetrics and Gynecology, 223 (2): 143–151, doi:10.1016/j.ajog.2020.03.001, PMID 32151611 
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  39. ^ Dahm-Kähler, Pernilla; Wranning, Caiza; Lundmark, Cecilia; Enskog, Anders; Mölne, Johan; Marcickiewicz, Janusz; El-Akouri, Randa Racho; McCracken, John; et al. (2008). "Transplantation of the uterus in sheep: Methodology and early reperfusion events". Journal of Obstetrics and Gynaecology Research. 34 (5): 784–793. doi:10.1111/j.1447-0756.2008.00854.x. PMID 18834335. 
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  44. ^ Moore FD (2000). "Ethical problems special to surgery: surgical teaching, surgical innovation, and the surgeon in managed care". Arch Surg. 135 (1): 14–16. doi:10.1001/archsurg.135.1.14. PMID 10636340. 
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