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Son dakika: Koronavirüsle mücadelede yeni dönem! İyileşmiş hastanın kanıyla.. Son dakika haberi... Türkiye'de koronavirüsle mücadele tüm hızıyla sürüyor. Son olarak Sağlık Bakanlığı ve Kızılay bu kapsamda harekete geçti, üniversiteler destek verdi; koronavirüs salgınıyla mücadelede iyileşmiş hastalardan alınacak plazma kan ürünü ile kritik durumda olan hastaların tedavisine başlanacak. takvim.com.tr Giriş Tarihi : 31 Mart 2020 , 10:52 Güncelleme Tarihi : 31 Mart 2020 , 10:57
Koronavirüs salgınında ağır durumdaki hastalar için çare olabileceği düşünülen pasif antikor tedavisine Türkiye'de de start veriliyor. Sağlık Bakanlığı koordinasyonunda, Kızılay ve Hacettepe Tıp Fakültesi başta olmak üzere çeşitli üniversitelerin desteği ile çok yakın bir tarihte Covid-19 geçirip sağlığına kavuşmuş ve testleri negatif sonuç vermiş gönüllü donörlerden alınacak kandan, hastalığa karşı gelişen antikorların bolca bulunduğu plazma ayrılarak ağır durumdaki hastalara nakledilecek. Covid-19 salgınında dünyanın gündeminde olan plazma naklinin ülkemizde de başlatılacağının işaretini ilk olarak, Türk Kızılayı Başkanı Dr. Kerem Kınık, sosyal medya hesabından verdi ve "Bugün önemli bir proje üzerinde çalıştık ve hastalarımız için ümit veren bir noktaya geldik Hacettepe, Kızılay Kan/BioBanka ve Sağlık Bakanlığı Korona Bilim Kurulundan Hocalarımız, Plazma Transfüzyon Tedavisinin etkinliği konusunda görüş birliğindeler" dedi. Bu tedavinin Türkiye'de uygulanabilmesinin en önemli destekçilerden biri olan Hacettepe Üniversitesi Tıp Fakültesi Hematoloji Bilim Dalı Öğretim Üyesi ve Hacettepe Hastaneleri Kan Merkezi ve Aferez Ünitesi Direktörü Prof. Dr. Osman Özcebe, Demirören Haber Ajansı'na sürecin tüm detaylarını anlattı.
SAĞLIK BAKANLIĞI KOORDİNASYONUNDA KIZILAY ELİYLE YAPILACAK Prof. Dr. Özcebe, "Kızılay ve sağlık kurumlarımızın katkısı ile bu organizasyon ülkemizde de kolaylıkla yapılabilir. Bütün dünyada olduğu gibi Sağlık Bakanlığımız da bu işin farkında ve artık elimizde iyileşmekte olan hastalarımız da var. Dolayısıyla bir hafta 10 gün gibi bir süre daha geçtikten sonra, bu kişilerden plazma toplanmasına başlanacak, diye düşünüyorum. Bu projede Sağlık Bakanlığı'nın destekleyenlerin başında ise kan tedariğinin en büyük başrol oyuncusu olan Kızılay, üniversitelerimiz ki benim de mensubu bulunduğum Hacettepe Üniversitesi de dahil, her türlü bilgi ve 'Know How'larını bu sistemin kurulması için ortaya koyacak. Sağlık Bakanlığı ve bakanlığa bağlı idari ve sağlık birimleri de bu organizasyonun içinde olacak.
Bütün Avrupa ülkelerinde de bu iş bu şekilde yürütülüyor. Bu tedavi, tek başına, küçük ölçekli laboratuvarlarda yürütülebilecek bir organizasyon değil" dedi.
PLAZMALAR İKİNCİ SALGIN DALGASINDA DA KULLANILABİLİR Sistem uygulanmaya başlandığında toplanan plazmaların ihtiyaçtan fazla temin edilmesi durumunda, olası bir ikinci dalga koronavirüs salgınında da kullanılabileceğini vurgulayan Prof. Dr. Özcebe, "Bu plazmalar uygun şartlarda dondurularak saklanabilirse, ileride muhtemelen eritilerek tekrar kullanılabilir. Ayrıca özel sanayi tipi ilaç ve kan ürünü üreten fabrikalarda, bu plazmaların işlenerek konsantre hale getirilip hazır ticari preparatlar haline de dönüştürülmesi de mümkün. Virüs bu arada bariz bir mutasyon geçirmez ve elimizdeki antikorlara hala duyarlı kalabilirse, yani hedef tahtasında kalmaya devam ederse, böyle bir avantajı da söz konusu olabilir" diye konuştu.
ELDEKİ TÜM TEDAVİLERE RAĞMEN HASTALAR KAYBEDİLEBİLİYOR Vücudun kendi bağışıklık sisteminin geliştirdiği veya çocukluk çağından itibaren aşı ile oluşturulan antikorları, 'mikroplar vücudumuza girdiği zaman onları tanıyarak anında yok eden sihirli mermicikler' olarak tanımlayan Prof. Dr. Özcebe, şu bilgileri verdi: "Hedefe yönelik tanımlanmış silahlar diyebiliriz bunlara. Bir enfeksiyon geçirdiğiniz zaman, genellikle buna karşı bağışıklığınızın kalıcı olmasını sağlayan bu antikorlardır. Aşı ile antikorları oluşturduğumuz zaman da olası etkenlere karşı koruma sağlamış olursunuz. İyileşmiş olan kişinin kanından bu antikorları elde edip, enfeksiyonla savaşan ve bağışıklık sistemi zayıf olduğu için hastalığı ağır geçiren başka bir hastaya verdiğimiz zaman ise hastanın iyileşme sürecine önemli boyutta katkılarda bulunur. Buna pasif immünizasyon (bağışıklık) diyoruz."
'YENİ BİR YÖNTEMMİŞ GİBİ SUNULMASI YANLIŞ' Bu yöntemin yeni bir yöntemmiş gibi sunulmasının da doğru olmadığının altını çizen Prof. Dr. Özcebe, "Daha önce de pandemi (küresel salgın) ve endemi (bölgesel salgın) şeklinde seyretmiş olan pekçok enfeksiyonda bu yöntem kullanıldı. Bunun tipik örnekleri 2009 influenza (H1N1) endemisi, 2014'de Ebola ve 2015'te MERS, bütün bu salgınlar sırasında bu antikor transferi yani pasif immünizasyon kullanılmıştır. Covid-19 salgınında niye tekrar gündeme geldi? Çünkü yüzde 5'lik bir hastada, hastalık ağır seyrediyor; hastaların yaklaşık yüzde 1'ini de kaybediyoruz. Bu, yüzde 5'lik hastanın ise bir kısmı, yoğun bakımlarda solunum desteğine ihtiyaç duyuyor. Yani elimizdeki denenmiş ve kısmi olarak etkinliği gösterilmiş tüm tedavi yaklaşımlarına rağmen kesin çözümü yok. Hastalarımızın bir kısmını kaybediyoruz bu nedenle. Uygun bir organizasyonla, yapılması zor bir işlem değil plazma nakli ile pasif antikor tedavisi aslında. Türkiye'de de Sağlık Bakanlığı önderliğinde bu tedavi yapılabilir" dedi.
AVRUPA STANDARTLARINDA KAN BANKACILIĞI SİSTEMİMİZ VAR Türkiye'nin bu iş için alt yapısının hazır ve Avrupa standartlarında çok kuvvetli bir kan bankacılığı sistemi olduğunu vurgulayan Prof. Dr. Osman Özcebe, "Avrupa Birliği direktiflerine tamamen uygun, son derece eğitimli, donanımlı yeterli teknik altyapısı olan kan bankacılığı sistemimiz var. Kızılay bu sistemi büyük oranda kontrol edip işletiyor hali hazırda. Dolayısıyla Türkiye'de bu yöntemin uygulanmaması için hiçbir neden yok. Etkili olacağı hasta grupları ise tanımlanmış durumda: Yoğun bakımda destek tedavisine ihtiyaç duyan hastalar. Ayrıca, kan transferi yaptığımız kişiye de aldığımız kan ürünün zarar vermemesi için katı kurallarımız var. Bağış yapacak kişilerin de evrensel kan bankacılığı donör kriterlerine uygun olması lazım. Enfeksiyonu geçirdikten, semptomları bittikten en az 2 hafta sonra hem boğazdan alınan sürüntü, hem de alınan kan örneğinin PCR testlerinde negatif çıkmış olması gerekiyor. Donörden alınacak serumun ne şekilde işleneceği, hangi testlerin yapılacağı, bütün bunlar tanımlandı. Bu plazma naklinin çok fazla riski de yok" şeklinde konuştu.
DÜNYADA DA BAĞIŞÇI ÇAĞRILARI BAŞLADI Koronavirüs salgınında pasif antikor tedavisinin ilk olarak Çin'deki meslektaşları tarafından küçük ölçekli çalışmalarla denendiğini hatırlatan Prof. Dr. Özcebe, sözlerini şöyle noktaladı: "Daha sonrasında Batı dünyasında yapılan 5 hastalık bir çalışmada, pasif antikor transferinin ağır hastaların yoğun bakımdan, solunum desteğinden kurtulma ve taburcu olma şansını artırdığı gösterildi. Buna binaen dünyanın önde gelen büyük sağlık kuruluşlarından WHO (Dünya Sağlık Örgütü) ile Amerikan Gıda ve İlaç Dairesi FDA, bu ayın 24'ü itibariyle bu salgında bu yöntemin kullanılabileceğini resmi olarak açıkladı ve ABD başta olmak üzere kamuoyuna da ilanlar verilip Covid-19 geçirip iyileşmiş kişilere plazma bağışında bulunma çağrısı yapıldı."