{"id":2926,"date":"2026-09-06T17:56:26","date_gmt":"2026-09-06T17:56:26","guid":{"rendered":"https:\/\/bookinghospital.org\/?p=2926"},"modified":"2026-09-06T18:12:51","modified_gmt":"2026-09-06T18:12:51","slug":"paired-exchange-kidney-transplant","status":"publish","type":"post","link":"https:\/\/bookinghospital.org\/tr\/eslestirilmis-takas-bobrek-nakli\/","title":{"rendered":"E\u015fle\u015ftirilmi\u015f B\u00f6brek Nakli"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"2926\" class=\"elementor elementor-2926\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7b32e7c e-con-full e-flex e-con e-parent\" data-id=\"7b32e7c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0c8ce02 elementor-widget elementor-widget-html\" data-id=\"0c8ce02\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div id=\"bh\">\n\n<section class=\"hero\">\n  <div class=\"in\">\n    <p class=\"eyebrow\">B\u00f6brek nakli \u00b7 Nakil \u00f6ncesi<\/p>\n    <h1>Biri sana bir b\u00f6brek vermeye raz\u0131. Sadece uymuyor.<\/h1>\n    <p class=\"lead\">E\u015fle\u015ftirilmi\u015f de\u011fi\u015fim, aileler aras\u0131nda vericileri takas ederek bunu \u00e7\u00f6zer. Uyumlu olmayan ancak g\u00f6n\u00fcll\u00fc bir vericisi olan neredeyse t\u00fcm hastalar bu \u015fekilde nakil olabilir ve zincirler yedi \u00e7ift derinli\u011fe kadar ula\u015fabilir.<\/p>\n    <p class=\"meta\">Yazan <b style=\"color:#fff\">Prof. Dr. Murat Tuncer<\/b> \u00b7\n       Kitab\u0131ndan uyarlanm\u0131\u015ft\u0131r <i>B\u00f6brek Nakli \u2014 Soru ve Cevaplarla<\/i><\/p>\n  <\/div>\n<\/section>\n\n<section class=\"wrap\">\n\n  <div class=\"ozet\">\n    <h2>K\u0131sa cevap<\/h2>\n    <ul>\n      <li>E\u011fer ba\u011f\u0131\u015f\u00e7\u0131n\u0131z istekli ancak uyumsuzsa, <b>b\u00f6brekleri ba\u015fka bir hastaya gidebilir<\/b> \u2014 ve o hastan\u0131n ba\u011f\u0131\u015f\u00e7\u0131s\u0131 size veriyor.<\/li>\n      <li>Her iki nakil de o zaman <b>tamamen uyumlu<\/b>. \u00d6zel haz\u0131rl\u0131k yok, antikor uzakla\u015ft\u0131rma yok.<\/li>\n      <li>\u015eunun i\u00e7in i\u015fe yar\u0131yor <b>kan grubu uyu\u015fmazl\u0131\u011f\u0131<\/b> ve \u015fu taraf\u00e7a engellenen \u00e7iftler i\u00e7in:\n          <b>pozitif \u00e7apraz kar\u015f\u0131la\u015ft\u0131rma<\/b>.<\/li>\n      <li>De\u011fi\u015fimler iki \u00e7ift ile s\u0131n\u0131rl\u0131 de\u011fildir. <b>Yedi zincir<\/b> ger\u00e7ekle\u015ftirilmi\u015ftir.<\/li>\n      <li>T\u00fcrkiye'de \u00e7apraz nakiller ayarlanabilir <b>herhangi iki nakil merkezi aras\u0131nda<\/b>, kar\u015f\u0131l\u0131kl\u0131 r\u0131za ile, bir komisyona \u00e7\u0131kmaks\u0131z\u0131n.<\/li>\n    <\/ul>\n  <\/div>\n\n  <h2>\u00c7\u00f6zd\u00fc\u011f\u00fc sorun<\/h2>\n\n  <p>Bir koca e\u015fine b\u00f6brek vermek istiyor. Bir k\u0131z babas\u0131na vermek istiyor. \u0130stekliler, sa\u011fl\u0131kl\u0131lar ve haz\u0131rlar \u2014 ve sonra testler sonu\u00e7lan\u0131yor ve ikili uyu\u015fmuyor.<\/p>\n\n  <p>Buna genellikle iki \u015fey neden olur:<\/p>\n\n  <ul>\n    <li><b>Kan grubu uyu\u015fmazl\u0131\u011f\u0131<\/b> \u2014 vericinin kan grubu al\u0131c\u0131n\u0131nkine uymuyor.<\/li>\n    <li><b>Al\u0131c\u0131n\u0131n kan\u0131ndaki antikorlar<\/b> \u2014 s\u00f6z konusu vericiye kar\u015f\u0131 pozitif \u00e7apraz kar\u015f\u0131la\u015ft\u0131rma.<\/li>\n  <\/ul>\n\n  <p>Her iki durumda da b\u00f6brek sa\u011flam. Sadece yanl\u0131\u015f ki\u015fiye y\u00f6nlendirilmi\u015f.<\/p>\n\n  <div class=\"box\">\n    <span class=\"etiket\">Fikir<\/span>\n    <p>E\u011fer iki aile de ayn\u0131 \u015fekilde mahsur kald\u0131ysa, <b>ba\u011f\u0131\u015f\u00e7\u0131lar\u0131 de\u011fi\u015ftir<\/b>. Vericiniz hastas\u0131na ba\u011f\u0131\u015fta bulunur; onun vericisi de size ba\u011f\u0131\u015fta bulunur. Her iki nakil de uyumludur ve iki ameliyat, iki \u00e7\u0131kmaz sokaktaki durumu ortadan kald\u0131r\u0131r.<\/p>\n  <\/div>\n\n  <h2>De\u011fi\u015fimin nas\u0131l d\u00fczenlendi\u011fi<\/h2>\n\n  <p>Kendi akrabas\u0131yla ilerleyemeyen \u00e7iftler \u00e7apraz nakil listelerine dahil edilir. E\u015fle\u015ftirme yaln\u0131zca kan grubuna g\u00f6re yap\u0131lmaz \u2014 merkez ayr\u0131ca de\u011ferlendirir <b>doku uyumu, ya\u015f ve altta yatan hastal\u0131klar<\/b> aileleri e\u015fle\u015ftirirken.<\/p>\n\n  <div class=\"soru\">\n    <h3>Basit bir ikili al\u0131\u015fveri\u015f<\/h3>\n\n    <p>En yayg\u0131n formu. Kan grubu A olan ve g\u00f6n\u00fcll\u00fc vericisi B grubu olan bir al\u0131c\u0131 al\u0131n ve ayna pozisyonundaki ba\u015fka bir \u00e7ift:<\/p>\n\n    <div class=\"tblwrap\">\n      <table>\n        <thead>\n          <tr><th><\/th><th>Ba\u011f\u0131\u015f\u00e7\u0131<\/th><th>Al\u0131c\u0131<\/th><th>b\u00f6brek ba\u011f\u0131\u015flar<\/th><\/tr>\n        <\/thead>\n        <tbody>\n          <tr><td><b>\u00c7ift 1<\/b><\/td><td>B Tipi<\/td><td>Tip A<\/td><td>\u00c7ift 2'nin Al\u0131c\u0131s\u0131<\/td><\/tr>\n          <tr><td><b>E\u015f 2<\/b><\/td><td>Tip A<\/td><td>B Tipi<\/td><td>\u00c7ift 1'in Al\u0131c\u0131s\u0131<\/td><\/tr>\n        <\/tbody>\n      <\/table>\n    <\/div>\n\n    <p>Birbirleriyle uyumsuz iki \u00e7ift, uyumlu iki nakle d\u00f6n\u00fc\u015f\u00fcr. Kendi uyumlu don\u00f6r\u00fc olmayan A veya B kan grubundaki hastalar bunun i\u00e7in do\u011fal adaylard\u0131r.<\/p>\n  <\/div>\n\n  <div class=\"soru\">\n    <h3>\u00dc\u00e7l\u00fc de\u011fi\u015fimler ve O grubu bir don\u00f6r\u00fcn neden de\u011ferli oldu\u011fu<\/h3>\n\n    <p>De\u011fi\u015fimler ikililerle s\u0131n\u0131rl\u0131 de\u011fildir. Don\u00f6r\u00fcn\u00fcn kan grubu O, al\u0131c\u0131n\u0131n ise kan grubu A veya B oldu\u011fu \u2014 kan grubundan uyumlu, ancak al\u0131c\u0131n\u0131n kan\u0131ndaki antikorlar nedeniyle engellenmi\u015f \u2014 bir aile grubu d\u00fc\u015f\u00fcn\u00fcn.<\/p>\n\n    <p>O ikili birleyebilir <b>\u00fc\u00e7l\u00fc de\u011fi\u015fim<\/b>. 0atif bir b\u00f6brek herhangi bir al\u0131c\u0131ya gidebilece\u011fi i\u00e7in, onlar\u0131n vericisi zinciri \u00e7\u00f6zer \u2014 ve bunu yaparak yaln\u0131zca kendileri i\u00e7in de\u011fil, kan gruplar\u0131 uyu\u015fmayan di\u011fer iki aile i\u00e7in de nakli m\u00fcmk\u00fcn k\u0131lar.<\/p>\n\n    <p>G\u00f6n\u00fcll\u00fc bir 0 grubu vericinin, kendi e\u015fle\u015fme \u00e7ifti t\u0131kal\u0131 g\u00f6r\u00fcnse bile orant\u0131s\u0131z bir \u015fekilde bu y\u00fczden faydal\u0131d\u0131r.<\/p>\n  <\/div>\n\n  <div class=\"soru\">\n    <h3>Domino zincirleri<\/h3>\n\n    <p>Yeterli say\u0131da \u00e7ift ile de\u011fi\u015fimler zincire d\u00f6n\u00fc\u015f\u00fcr. Her ba\u011f\u0131\u015f\u00e7\u0131 s\u0131radaki al\u0131c\u0131ya ba\u011f\u0131\u015f yapar ve tek bir zincir, koordine edilmi\u015f tek bir operasyonla bir\u00e7ok hastaya nakil yapabilir.<\/p>\n\n    <p>Olas\u0131 d\u00fczenlemelerin say\u0131s\u0131 eklenen her \u00e7iftle birlikte artt\u0131\u011f\u0131 i\u00e7in, bu, organ s\u0131k\u0131nt\u0131s\u0131na kar\u015f\u0131 bug\u00fcn mevcut olan en b\u00fcy\u00fck pratik yan\u0131tt\u0131r.<\/p>\n\n    <div class=\"box\">\n      <span class=\"etiket\">Kay\u0131tlarda<\/span>\n      <p>The <b>Amerika k\u0131tas\u0131 d\u0131\u015f\u0131nda d\u00fcnyan\u0131n herhangi bir yerinde ger\u00e7ekle\u015ftirilen ilk yedi \u00e7ift domino \u00e7apraz nakli<\/b> ekibimiz taraf\u0131ndan ger\u00e7ekle\u015ftirilmi\u015ftir.<\/p>\n    <\/div>\n  <\/div>\n\n  <h2>Ameliyat\u0131n nas\u0131l yap\u0131ld\u0131\u011f\u0131<\/h2>\n\n  <p>\u00c7apraz nakilde ameliyatlar art arda ger\u00e7ekle\u015fmez. <b>Al\u0131c\u0131n\u0131n ve vericinin ameliyatlar\u0131 ayn\u0131 anda ba\u015flamaktad\u0131r.<\/b>, ve b\u00f6brekler ayn\u0131 anda \u00e7\u0131kar\u0131l\u0131p nakledilir.<\/p>\n\n  <p>Bu kas\u0131tl\u0131d\u0131r. Don\u00f6rleri halihaz\u0131rda organ ba\u011f\u0131\u015flam\u0131\u015fken bir ailenin nakil olup di\u011ferinin geride kalmas\u0131 ihtimalini ortadan kald\u0131r\u0131r; bu, e\u015fzamanl\u0131 ameliyatlar\u0131n tasar\u0131m\u0131 gere\u011fi ortadan kald\u0131rd\u0131\u011f\u0131 bir adalet sorunudur.<\/p>\n\n  <h2>T\u00fcrkiye'deki hukuki durum<\/h2>\n\n  <p>\u00c7apraz nakil, 1 Haziran 2000 tarihli ve 24066 say\u0131l\u0131 Resmi Gazete'de yay\u0131mlanan Organ ve Doku Nakli Hizmetleri Y\u00f6netmeli\u011fi ile d\u00fczenlenmektedir.<\/p>\n\n  <p>\u0130lgili d\u00fczenlemeye g\u00f6re, canl\u0131 vericiden organ ba\u011f\u0131\u015f\u0131na \u015furadan izin verilmektedir:<\/p>\n\n  <ul>\n    <li>Al\u0131c\u0131n\u0131n <b>e\u015f<\/b>, \u00e7iftin fiilen en az iki y\u0131ld\u0131r birlikte ya\u015fad\u0131\u011f\u0131 yer<\/li>\n    <li><b>D\u00f6rd\u00fcnc\u00fc dereceye kadar kan ve kay\u0131n h\u0131s\u0131mlar\u0131<\/b>, d\u00f6rd\u00fcnc\u00fc derece dahil<\/li>\n  <\/ul>\n\n  <div class=\"box\">\n    <span class=\"etiket\">\u0130nsanlar\u0131 \u015fa\u015f\u0131rtan k\u0131s\u0131m<\/span>\n    <p>\u00c7apraz nakiller, kay\u0131tl\u0131 hastalar aras\u0131nda ger\u00e7ekle\u015ftirilebilir <b>herhangi iki nakil merkezi<\/b>, kar\u015f\u0131l\u0131kl\u0131 r\u0131za ile, <b>etik kuruluna ba\u015fvurmadan<\/b>.<\/p>\n    <p>Bu pratik a\u00e7\u0131dan \u00f6nemlidir: merkezinizin her iki \u00e7ifti de elinde bulundurmas\u0131 gerekmez. Ba\u015fka bir merkezde e\u015fle\u015fen bir \u00e7ift varsa, takas do\u011frudan ayarlanabilir.<\/p>\n  <\/div>\n\n  <h2>Sorulmaya de\u011fer sorular<\/h2>\n\n  <ul>\n    <li><b>\u00c7iftim \u00e7apraz nakil listesinde mi?<\/b> \"Uyumsuzsunuz\" denmesi, bir de\u011fi\u015fim program\u0131na kabul edilmekle ayn\u0131 \u015fey de\u011fildir.<\/li>\n    <li><b>Bu merkezin eri\u015fimi oldu\u011fu listeler hangileridir?<\/b> Daha b\u00fcy\u00fck bir havuz, daha h\u0131zl\u0131 bir e\u015fle\u015fme demektir.<\/li>\n    <li><b>\u00dc\u00e7l\u00fc veya zincirleme bir d\u00fczenleme d\u00fc\u015f\u00fcn\u00fcld\u00fc m\u00fc<\/b>, sadece do\u011frudan bir takas de\u011fil mi?<\/li>\n  <\/ul>\n\n  <div class=\"yazar\">\n    <div class=\"rozet\">MT<\/div>\n    <div>\n      <h3>Prof. Dr. Murat Tuncer<\/h3>\n      <p>Nefrolog ve nakil hekimi. Ekibi, Amerikan k\u0131tas\u0131 d\u0131\u015f\u0131nda ilk yedi \u00e7iftli domino \u00e7apraz naklini ger\u00e7ekle\u015ftirmi\u015f ve ABO uyumsuz b\u00f6brek naklini T\u00fcrkiye'ye kazand\u0131rm\u0131\u015ft\u0131r. Yazar\u0131: <i>B\u00f6brek Nakli \u2014 Soru ve Cevaplarla<\/i> (\u0130stanbul, 2020).<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"cta\">\n    <h2>Bize her iki kan grubunu ve \u00e7apraz kar\u015f\u0131la\u015ft\u0131rma sonucunu g\u00f6nderin<\/h2>\n    <p>Sizin ve ba\u011f\u0131\u015f\u00e7\u0131n\u0131z\u0131nkini. E\u015fle\u015ftirilmi\u015f bir takas\u0131n sizin durumunuzda ger\u00e7ek\u00e7i olup olmad\u0131\u011f\u0131n\u0131 ve neleri gerektirece\u011fini size bildirece\u011fiz.<\/p>\n    <div class=\"btns\">\n      <a class=\"btn btn-1\" href=\"\/medical-tourism\/\">T\u0131bbi raporlar\u0131n\u0131z\u0131 g\u00f6nderin<\/a>\n      <a class=\"btn btn-2\" href=\"\/blood-type-incompatible-kidney-transplant\/\">Kan grubu uyu\u015fmazl\u0131\u011f\u0131<\/a>\n    <\/div>\n  <\/div>\n\n  <div class=\"uyari\">\n    <p><b>T\u0131bbi sorumluluk reddi.<\/b> Bu makale, yay\u0131mlanm\u0131\u015f bir kitaptan uyarlanm\u0131\u015f genel bilgi niteli\u011findedir. Ki\u015fisel t\u0131bbi tavsiye niteli\u011fi ta\u015f\u0131maz, doktor-hasta ili\u015fkisi kurmaz ve sizi tedavi eden hekimin de\u011ferlendirmesinin yerini alamaz. Canl\u0131 ba\u011f\u0131\u015f ve \u00e7apraz ba\u011f\u0131\u015f ile ilgili d\u00fczenlemeler \u00fclkeden \u00fclkeye farkl\u0131l\u0131k g\u00f6sterir ve zamanla de\u011fi\u015febilir. Tedaviniz hakk\u0131nda karar vermeden \u00f6nce her zaman kendi nefrologunuza veya nakil merkezinize dan\u0131\u015f\u0131n.<\/p>\n  <\/div>\n\n  <div class=\"kaynak\">\n    <h3>Kaynak\u00e7a<\/h3>\n    <ol>\n      <li>Organ ve Doku Nakli Hizmetleri Y\u00f6netmeli\u011fi. Resm\u00ee Gazete, 1 Haziran 2000, say\u0131: 24066.<\/li>\n      <li class=\"kendi\"><b>Tuncer M<\/b>, ve ark. ABO uyumsuz b\u00f6brek nakli: T\u00fcrkiye'deki ilk olgular. <i>Transplant Proc<\/i> 2012;44(6):1703\u20135.<\/li>\n      <li>Knoll G, Cockfield S, Blydt-Hansen T, et al. B\u00f6brek nakli uygunlu\u011fu \u00fczerine Kanada Transplantasyon Derne\u011fi konsens\u00fcs k\u0131lavuzlar\u0131.\n        <i>CMAJ<\/i> 2005;173(10).<\/li>\n    <\/ol>\n  <\/div>\n\n<\/section>\n\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Kidney transplantation \u00b7 Before the transplant Someone is willing to give you a kidney. It just does not fit. Paired exchange solves this by swapping donors between families. Almost every patient with a willing but incompatible donor can be transplanted this way \u2014 and the chains can run seven pairs deep. Written by Prof. Dr. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"_surecart_dashboard_logo_width":"180px","_surecart_dashboard_show_logo":true,"_surecart_dashboard_navigation_orders":true,"_surecart_dashboard_navigation_invoices":true,"_surecart_dashboard_navigation_subscriptions":true,"_surecart_dashboard_navigation_downloads":true,"_surecart_dashboard_navigation_billing":true,"_surecart_dashboard_navigation_account":true,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_joinchat":[],"footnotes":""},"categories":[16],"tags":[],"class_list":["post-2926","post","type-post","status-publish","format-standard","hentry","category-kidney-transplant-guide"],"_links":{"self":[{"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts\/2926","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/comments?post=2926"}],"version-history":[{"count":7,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts\/2926\/revisions"}],"predecessor-version":[{"id":2940,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts\/2926\/revisions\/2940"}],"wp:attachment":[{"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/media?parent=2926"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/categories?post=2926"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/tags?post=2926"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}