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transfuziuli medicinis principebi

transfuziuli medicinis principebi. Tbilisi, saqarTvelo seqtemberi/oqtomberi, 2010 kristofer gresensi , M.D. VP & Medical Director, Clinical Services BloodSource. transfuziuli medicinis principebi. miznebi am prezentaciis dasasruls, monawileebs eqnebaT saSualeba Seajamon, . . .

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transfuziuli medicinis principebi

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  1. transfuziulimedicinisprincipebi Tbilisi, saqarTvelo seqtemberi/oqtomberi, 2010 kristofer gresensi, M.D. VP & Medical Director, Clinical Services BloodSource

  2. transfuziuli medicinis principebi miznebi am prezentaciis dasasruls, monawileebs eqnebaT saSualeba Seajamon, . . . sisxlis komponentebis warmoebis mizezebi, ermasis, plazmis, Trombomasisa da krioprecipitatis swori gamoyeneba, CMV- uaryofiTi da iradirebuli ujreduli komponentebis gamoyenebis standartebi

  3. transfuziuli medicinis principebi sqema mokle istoriuli eqskursi sisxlis komponentebis warmoeba transfuziis mtkicebulebebze dafuZnebuli Cvenebebi: (mTliani sisxli) ermasa plazma Trombomasa krioprecipitati specialuri (CMV-uaryofiTi an/da iradirebuli) produqti

  4. transfuziuli medicinis principebi mokle istoria

  5. 1665 – sisxlis 1-li dokumentirebuli gadasxma cxovelidan-cxovelze ZaRlidan-ZaRlze sisxlis gadasxma riCard laueris mier. From Petz and Swisher’s Clinical Practice of Transfusion Medicine, 2nd ed., 1989.

  6. 1667 – sisxlis pirveli dokumentirebuli gadasxma cxovelidan-adamianze Jan baptist denisi usxams 15 wlis biWs kravis sisxls. From Zmijewski’s Immunohematology.

  7. 1818 – sisxlis pirveli dokumentirebuli gadasxma adamianidan-adamianze sisxlis gadasxmis sferoSi 150-wliani uZraobis Semdeg, jeims blandeli usxams pacients adamianis sisxls. From Petz and Swisher’s Clinical Practice of Transfusion Medicine, 2nd ed., 1989.

  8. 1800-ianebi - gamoyenebaSia mravalnairi xelsawyo donoruli sisxlis Sesagroveblad (Tqven azriT, sisxlis dRevandeli samsaxurebi eCexebian problemebs ganmeorebiTi donorebis mozidvisas?) From Petz and Swisher’s Clinical Practice of Transfusion Medicine, 2nd ed., 1989.

  9. 1900 – ABH sisxlisjgufebisidentifikacia sisxlis jgufebis tipirebisas karl landStainerma aRmoaCina ABH sistema (dRevandeli A jgufis,B jgufis da 0 jgufis Sesabamisi). 1902-Si misma mimdevrebma pirvelad aRmoaCines AB jgufis mqone individi. From Transfusion, Vol. 1, p. 2 (1961)

  10. amas mohyva mravali axali eriTrocituli antigenis aRmoCena • Rh (C, c, D, E, e, …) • Kell (K, k, …) • Kidd (Jka, Jkb, …) • Duffy (Fya, Fyb, …) • MNSs, … • Lewis (Lea, Leb) • … … …

  11. adreuli 1900-ianebi – sisxlis miwodeba A wertilidan B wertilSi pirdapiri, “donori-pacienti” anastomozi amerikeli qirurgis, jorj grilis mier. From Petz and Swisher’s Clinical Practice of Transfusion Medicine, 2nd ed., 1989.

  12. 1914 –Tanamedrove antikoagulaciis dabadeba citrati pirvelad iqna gamoyenebuli sisxlis Sededebis sawinaaRmdegod. From Petz and Swisher’s Clinical Practice of Transfusion Medicine, 2nd ed., 1989.

  13. 1939/40 – aRmoaCinesRh-faqtoridaHDFN-is mizezi livainma, vinerma da maTma kolegebma erTiani ZalisxmeviT gaakeTes fundamenturi aRmoCenebi. From Netter Monograph Series

  14. 1940-ianebi – plazmis produqtebis damzadeba • edvin koni nergavs plazmis fraqcionirebis pirvel meTods, plazmis komponentebis “konis fraqciebad” gamosayofad. • jon elioti nergavs vakuumian boTls/sisxlis konteiners

  15. 1940-ianebi – plazmis produqtebis damzadeba Carlz driu iwyebs programas “sisxli britaneTisaTvis” – mSrali plazmis didi odenobiT sawarmoeblad. From American Red Cross Museum

  16. sisxli britaneTisaTvis (II msoflio omi) • proeqti niu iorkis hospitalebSi didi odenobiT sisxlis Sesagroveblad. • SemuSavebulia mSrali plazmis paketebi, transportirebis, SefuTvisa da Senaxvis gasaioleblad. • plazmis samxedro paketi Seicavs Tunuqis 2 qilas 400ml-iani boTlebiT. 1 gamoxdili wylisa da 1 mSrali plazmisaTvis. • rekombinacia 3 wuTSi. vargisia 4 sT.

  17. mSrali plazmis paketi (II mo)

  18. 1950’ianebi da 1960’ianebi • 1953 – Carl Walter da W.P. Murphy, Jr. nergaven plastikis sisxlis CanTas. • imave dros inergeba gamacivebeli centrifuga. • zemoTnaxsenebi ori inovacia biZgs aZlevs komponentebis warmoebas. • 1964 – Cndeba plazmaferezi, rogorc plazmis Segrovebis meTodi.

  19. magram, ABO mniSvneloba faravs sxva yvelafers… From Petz and Swisher’s Clinical Practice of Transfusion Medicine, 2nd ed., 1989.

  20. transfuziuri medicinis principebi sisxlis komponentebis warmoeba

  21. rogorvamzadebTsisxliskomponentebs Segrovebisprocesi • mTlianisisxlisagan: • mTliansisxlsvagrovebT • janmrTelidonorebisagan • sterilursisxlisCanTebSi, • romlebicSeicaven • antikoagulantsdakonservants. (2) aferezissaSualebiT: manqanebiintegrirebulicentrifugebiTyofendonorissisxlsindividualurkomponentebad(e.g., Trombocitebi, plazma, eriTrocitebidaa.S.). saWirokomponentigrovdebapaketSi, danarCenikiubrundeba donors.

  22. donoris gamokiTxvis procesi TiTis Cxvleta sisxlis nimuSisaTvis

  23. CuSO4iT hemoglobinis gansazRvra Note: am miznisaTvis SeiZleba sxva meTodebis gamoyenebac

  24. wnevis, pulsis da temperaturis Semowmeba

  25. sisxlisaRebisprocesi flebotomiis adgilis dezinfeqcia donaciamde flebotomia (16 Gauge nemsi)

  26. sisxlisaRebisprocesi sisxlis Sesagrovebeli multi-paketiani sistema sisxlis nakadi Caedineba pirvelad CanTaSi

  27. sisxlisaRebisprocesi

  28. sisxliskomponentebisdamzadebamTlianisisxlisagan (aSS-s magaliTi) eriTrocitebi centrifuga (dabali g) WHOLE BLOOD + TrombocitebiTmdidariplazma

  29. komponentebis dasamzadebeli centrifuga

  30. mravalpaketiani sisxlis CanTa

  31. centrifugis Signeuloba

  32. komponentebiswarmoebamTlianisisxlisagan eriTrocitebi centrifugireba (maRali g) Trombocitebi + an plazma gayinva • leikoreduqcia • SesaZlo iradiacia • sxva + TrombocitebiTmdidariplazma axlad gayinuli plazma (agp) an 24 sT-Si gayinuli plazma

  33. komponentebiswarmoebamTlianisisxlisagan • galRoba (4° C) • centrifugireba axladgayinuli plazma (FFP) krioprecipitati + krio-gaRaribebuli plazma

  34. “narCenebis” Wkvianurigamoyeneba Semdgomi gadamuSavebisaTvis plazma • plazmisderivatebi • albumini • VIII faqtori • imunoglobulini • sxva

  35. sisxliSeiZlebaoptimaluradiqnasgamoyenebulikomponentebissaxiT, mTlianisisxlisnacvlad RBC PLT FFP

  36. sisxlis “safantiviTgasrola” da...

  37. komponenturiTerapia

  38. aferezisprincipebi plazma Tromboc. mononuklearebi granulocitebi eriTrocitebi mTliani sisxli mTliani sisxli (vena) (vena) antikoagulantis damateba sisxlis darCenili Semadgenlebis dabruneba sisxlis Semadgenlebi iyofa centrifugiT da grovdeba SerCeviTad

  39. Caridian BCT Trima Accel

  40. Haemonetics PCS-2

  41. afereziTSegrovebuliplazma Cveulebriv 200 mL-dan800 mL-mde afereziT damzadebuli agp

  42. sinjarebi donoruli sisxliT mzad aris testirebisaTvis

  43. testireba infeqciur markerebze (Abbott PRISM)

  44. Sagasis daavadebis testireba (Ortho Platform)

  45. NAT – HIV, HBV, HCV, and WNV

  46. Olympus PK-7200 (ABO, Rh, syphilis)

  47. CBC analysis by Pentra XL-80

  48. Trombocitebis baqteriuli analizi. xarisxis kontrolis testi BacT/ALERT-iT

  49. testireba ABO Rh eriTrocituriantisxeulebisskriningi infeqciuridaavadebebi sifilisi HBsAg Anti-HIV-1/2 Anti-HBc

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