{"id":2932,"date":"2026-09-06T18:06:21","date_gmt":"2026-09-06T18:06:21","guid":{"rendered":"https:\/\/bookinghospital.org\/?p=2932"},"modified":"2026-09-06T18:12:41","modified_gmt":"2026-09-06T18:12:41","slug":"preemptive-kidney-transplant","status":"publish","type":"post","link":"https:\/\/bookinghospital.org\/tr\/onleyici-bobrek-nakli\/","title":{"rendered":"Preemptif B\u00f6brek Nakli"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"2932\" class=\"elementor elementor-2932\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2bba7cb e-con-full e-flex e-con e-parent\" data-id=\"2bba7cb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c384381 elementor-widget elementor-widget-html\" data-id=\"c384381\" 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>En iyi nakil, diyalizden \u00f6nce yap\u0131land\u0131r.<\/h1>\n    <p class=\"lead\">Diyalizde ge\u00e7irilen her ay, naklin geri veremeyece\u011fi bir \u015feyler al\u0131p g\u00f6t\u00fcr\u00fcr. Yeterince erken yap\u0131l\u0131rsa bir nakil, hi\u00e7 diyaliz girmemek ve eski i\u015finize d\u00f6nmek i\u00e7in ger\u00e7ek\u00e7i bir \u015fans anlam\u0131na gelebilir.<\/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>A <b>\u00f6nleyici nakil<\/b> kronik diyaliz ba\u015flamadan \u00f6nce, b\u00f6brek filtrasyonu d\u00fc\u015ft\u00fc\u011f\u00fcnde yap\u0131lan <b>20 mL\/dak'n\u0131n alt\u0131nda<\/b>.<\/li>\n      <li>\u015eu anda <b>en ba\u015far\u0131l\u0131 tedavi<\/b> kronik b\u00f6brek hastal\u0131\u011f\u0131 i\u00e7in mevcuttur.<\/li>\n      <li>Nakledilen b\u00f6bre\u011fin ilk y\u0131lda if Etme riski \u015fu oranla d\u00fc\u015fmektedir: <b>52%<\/b>\n          diyaliz ba\u015flad\u0131ktan sonra yap\u0131lan nakil ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda.<\/li>\n      <li>Yaln\u0131zca <b>24%<\/b> bir y\u0131ldan uzun s\u00fcredir diyaliz tedavisi g\u00f6ren hastalar nakil sonras\u0131nda i\u015fe geri d\u00f6nmektedir. Preemptif hastalar aras\u0131nda, <b>en az yar\u0131s\u0131<\/b> yap.<\/li>\n      <li>Sevk i\u015flemi \u015fu tarihte ger\u00e7ekle\u015ftirilmelidir: <b>30\u2019un alt\u0131ndaki eGFR<\/b> \u2014 diyaliz zaten planlan\u0131yorken de\u011fil.<\/li>\n    <\/ul>\n  <\/div>\n\n  <h2>&quot;\u00d6nleyici&quot; kelimesinin anlam\u0131 nedir?<\/h2>\n\n  <p>Preemptif b\u00f6brek nakli, kronik b\u00f6brek hastas\u0131na yap\u0131lan bir nakildir <b>kronik bir diyaliz program\u0131na girmeden \u00f6nce<\/b>, glomer\u00fcler filtrasyon h\u0131z\u0131n\u0131n dakikada 20 mL'nin alt\u0131na d\u00fc\u015ft\u00fc\u011f\u00fc noktada.<\/p>\n\n  <p>Bu deneysel bir yol veya kestirme bir yol de\u011fildir. Kronik b\u00f6brek hastal\u0131\u011f\u0131 i\u00e7in ideal tedavi y\u00f6ntemidir ve ister diyalizden ister daha sonra yap\u0131lan bir nakilden daha iyi sonu\u00e7lar verir.<\/p>\n\n  <h2>Asl\u0131nda fark\u0131n ne oldu\u011fu<\/h2>\n\n  <p>Diyalize ba\u015fland\u0131ktan sonra yap\u0131lan nakle k\u0131yasla sa\u011flanan avantaj, hi\u00e7 de az\u0131msanacak bir \u015fey de\u011fildir.<\/p>\n\n  <div class=\"tblwrap\">\n    <table>\n      <thead>\n        <tr><th>Diyaliz sonras\u0131 nakil ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda<\/th><th>Preemptif nakil<\/th><\/tr>\n      <\/thead>\n      <tbody>\n        <tr>\n          <td>Greft yetmezli\u011fi riski, ilk y\u0131l<\/td>\n          <td><b>52% alt<\/b><\/td>\n        <\/tr>\n        <tr>\n          <td>\u0130kinci y\u0131ldan itibaren greft yetmezli\u011fi riski<\/td>\n          <td><b>86% alt<\/b><\/td>\n        <\/tr>\n        <tr>\n          <td>Reddedilme oranlar\u0131<\/td>\n          <td>Cevher <b>25% alt<\/b><\/td>\n        <\/tr>\n        <tr>\n          <td>\u00d6nceki i\u015fe d\u00f6n<\/td>\n          <td><b>En az 50%<\/b>, buna kar\u015f\u0131l\u0131k bir y\u0131ll\u0131k diyaliz tedavisinden sonra 24%<\/td>\n        <\/tr>\n      <\/tbody>\n    <\/table>\n  <\/div>\n\n  <p>Diyalizde ge\u00e7irilen s\u00fcrenin uzamas\u0131 ayr\u0131ca \u015funlarla ili\u015fkilidir: <b>ilk alt\u0131\n     ayda daha y\u00fcksek red oranlar\u0131<\/b> nakilden sonra. Bu ili\u015fki tek y\u00f6nl\u00fcd\u00fcr: beklemek hi\u00e7bir \u015feyi\n     iyile\u015ftirmez.<\/p>\n\n  <div class=\"box\">\n    <span class=\"etiket\">Greftin \u00f6tesinde<\/span>\n    <p>\u00d6nleyici nakil, diyalizin kendisiyle birlikte getirdi\u011fi sorunlardan \u2014 enfeksiyonlar,\n      kan nakilleri (bu, antikor d\u00fczeylerini y\u00fckseltir ve gelecekteki don\u00f6r se\u00e7eneklerini k\u0131s\u0131tlar), kalp\n      fonksiyon bozuklu\u011fu ve y\u00fcksek tansiyon \u2014 ka\u00e7\u0131nmak anlam\u0131na da gelir. Genel olarak hastaneye yat\u0131\u015f say\u0131s\u0131 daha azd\u0131r ve\n      graft fonksiyonunda gecikme daha az g\u00f6r\u00fcl\u00fcr.<\/p>\n  <\/div>\n\n  <h2>Kimsenin bahsetmedi\u011fi k\u0131s\u0131m: i\u015f<\/h2>\n\n  <p>Bu konu\u015fmalarda hayatta kalma istatistikleri \u00f6n plana \u00e7\u0131k\u0131yor ve \u00f6yle de olmal\u0131. Ancak \u00e7o\u011fu hasta i\u00e7in\n     as\u0131l soru daha basit: \u2014 <b>Hayat\u0131m\u0131 geri alabilecek miyim?<\/b><\/p>\n\n  <p>Burada rakamlar \u00e7ok \u00e7arp\u0131c\u0131. Bir y\u0131ldan uzun s\u00fcredir diyalize giren hastalar\u0131n\n     sadece <b>24%<\/b> nakil sonras\u0131nda i\u015flerine geri d\u00f6n\u00fcyorlar. \u00d6nleyici olarak nakil yap\u0131lan\n     hastalar aras\u0131nda, <b>en az yar\u0131s\u0131<\/b> \u00f6nceki yapt\u0131klar\u0131 i\u015fe geri d\u00f6nmek.<\/p>\n\n  <p>Diyalizde ge\u00e7irilen s\u00fcre sadece b\u00f6bre\u011fin iyile\u015fme \u015fans\u0131n\u0131 olumsuz etkilemekle kalmaz. Ayn\u0131 zamanda, bir naklin geri kazand\u0131rmas\u0131 beklenen \u00e7al\u0131\u015fma hayat\u0131n\u0131,\n     g\u00fcnl\u00fck rutini ve ba\u011f\u0131ms\u0131zl\u0131\u011f\u0131 da zedeler.<\/p>\n\n  <div class=\"soru\">\n    <h3>Bu sohbet ne zaman ba\u015flamal\u0131?<\/h3>\n\n    <p>Genellikle oldu\u011fundan daha erken. \u0130ki e\u015fik vard\u0131r ve bunlar ayn\u0131 de\u011fildir:<\/p>\n\n    <div class=\"tblwrap\">\n      <table>\n        <thead>\n          <tr><th>B\u00f6brek filtrasyonu (eGFR)<\/th><th>Ne olmas\u0131 gerekiyor<\/th><\/tr>\n        <\/thead>\n        <tbody>\n          <tr>\n            <td><b>30 mL\/dak'n\u0131n alt\u0131nda<\/b><br><span style=\"color:#7a7a7a\">A\u015fama 4<\/span><\/td>\n            <td>Tedavi se\u00e7enekleri hakk\u0131nda hasta e\u011fitimi \u2014 diyaliz <i>ve<\/i> transplantasyon.\n              <b>Bir nakil merkezine sevk.<\/b> Buras\u0131 bir sevk noktas\u0131d\u0131r, diyaliz haz\u0131rl\u0131k noktas\u0131 de\u011fil.<\/td>\n          <\/tr>\n          <tr>\n            <td><b>20 mL\/dakika alt\u0131nda<\/b><\/td>\n            <td>Preemptif nakil \u015fu \u015fekilde olmal\u0131d\u0131r <b>t\u00fcm hastalarda denendi<\/b> m\u00fcmk\u00fcn olan yerlerde.<\/td>\n          <\/tr>\n          <tr>\n            <td>10 mL\/dakika alt\u0131ndakiler<\/td>\n            <td>Diyaliz, e\u011fer bir nakil ger\u00e7ekle\u015fmediyse.<\/td>\n          <\/tr>\n        <\/tbody>\n      <\/table>\n    <\/div>\n\n    <p>eGFR 20 yerine 30'da sevk etmenin amac\u0131 zamand\u0131r. Hastan\u0131n se\u00e7enekleri anlamas\u0131, nakil de\u011ferlendirmesini tamamlamas\u0131 ve en \u00f6nemlisi \u2014\n       <b>potansiyel bir ba\u011f\u0131\u015f\u00e7\u0131 bul<\/b>. Bu s\u00fcre\u00e7, diyalizden \u00f6nceki son haftalara s\u0131\u011fd\u0131r\u0131lamaz.<\/p>\n  <\/div>\n\n  <div class=\"soru\">\n    <h3>Nakil, diyalizden daha m\u0131 pahal\u0131d\u0131r?<\/h3>\n\n    <p><b>Hay\u0131r \u2014 \u00e7ok daha ucuz.<\/b> Bir b\u00f6brek nakli hastas\u0131n\u0131n bak\u0131m maliyeti <b>\u00fc\u00e7te birinden az<\/b> uzun s\u00fcreli diyaliz maliyetinin.<\/p>\n\n    <p>\u00d6nleyici nakil; maliyetli komplikasyonlar\u0131 (gecikmi\u015f greft fonksiyonu, akut reddedilme, greft yetmezli\u011fi) \u00f6nleyerek bunu daha da azalt\u0131r. Maliyetin bir engel olarak ileri s\u00fcr\u00fcld\u00fc\u011f\u00fc durumlarda, kar\u015f\u0131la\u015ft\u0131rman\u0131n hangi zaman dilimi \u00fczerinden yap\u0131ld\u0131\u011f\u0131n\u0131 sormakta fayda vard\u0131r.<\/p>\n  <\/div>\n\n  <div class=\"box efsane\">\n    <span class=\"etiket\">\u00d6nerilen ile ger\u00e7ekle\u015fen aras\u0131ndaki fark<\/span>\n    <p>Uluslararas\u0131 rehberler, \u00f6nleyici nakillerin oran\u0131n\u0131 art\u0131rmay\u0131 hedeflemektedir\n      <b>26% \u2013 50%<\/b> t\u00fcm nakillerin. Bu hedefin var olma nedeni, diyalizden \u00f6nce nakil olabilecek hastalar\u0131n \u00e7o\u011funun olamamas\u0131d\u0131r.<\/p>\n    <p>Ola\u011fan neden t\u0131bbi de\u011fildir. Kimsenin onlar\u0131 zaman\u0131nda sevk etmemi\u015f olmas\u0131d\u0131r.<\/p>\n  <\/div>\n\n  <h2>Bununla ne yapmal\u0131?<\/h2>\n\n  <ul>\n    <li><b>eGFR de\u011ferinizi bilin.<\/b> Say\u0131 30'un alt\u0131ndaysa ve sizinle nakil konusu g\u00f6r\u00fc\u015f\u00fclmediyse, bunu kendiniz g\u00fcndeme getirin.<\/li>\n    <li><b>Canl\u0131 verici aramaya erken ba\u015flay\u0131n.<\/b> Bu, en uzun s\u00fcren ve \u00e7o\u011funlukla \u00e7ok ge\u00e7 b\u0131rak\u0131lan ad\u0131md\u0131r.<\/li>\n    <li><b>Merkezinizde de\u011ferlendirme ne kadar s\u00fcr\u00fcyor?.<\/b> Haz\u0131rl\u0131k d\u00f6nemi aylar s\u00fcrerse, siz beklerken \u00f6n al\u0131m penceresi kapanabilir.<\/li>\n    <li><b>Gereksiz kan nakillerinden ka\u00e7\u0131n\u0131n<\/b> diyalizdeyken \u2014 her biri antikorlar\u0131 art\u0131rabilir ve daha sonra don\u00f6r se\u00e7eneklerinizi daraltabilir.<\/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. Yazar\u0131: <i>B\u00f6brek Nakli \u2014 Soru ve Cevaplarla<\/i> (\u0130stanbul, 2020), kendi hastalar\u0131n\u0131n en s\u0131k sordu\u011fu sorular\u0131 yan\u0131tlamak i\u00e7in yaz\u0131lm\u0131\u015ft\u0131r.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"cta\">\n    <h2>Diyalize ba\u015flamadan \u00f6nce bize eGFR de\u011ferinizi g\u00f6nderin<\/h2>\n    <p>B\u00f6brek fonksiyonunuz d\u00fc\u015f\u00fcyorsa ve kimse nakil konusunu g\u00fcndeme getirmediyse, son testlerinizi bize g\u00f6nderin. Sizin durumunuzda \u00f6nleyici pencerenin hala a\u00e7\u0131k olup olmad\u0131\u011f\u0131n\u0131 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=\"\/category\/kidney-transplant-guide\/\">Daha fazla hasta rehberi<\/a>\n    <\/div>\n  <\/div>\n\n  <div class=\"uyari\">\n    <p><b>T\u0131bbi sorumluluk reddi.<\/b> Bu makale, yay\u0131nlanm\u0131\u015f bir kitaptan uyarlanan genel bilgiler i\u00e7ermektedir. Ki\u015fisel t\u0131bbi tavsiye niteli\u011finde de\u011fildir, doktor-hasta ili\u015fkisi kurmaz ve sizi tedavi eden hekimin de\u011ferlendirmesinin yerini alamaz. E\u015fik de\u011ferler ve sevk uygulamalar\u0131 hastadan hastaya ve merkezden merkeze de\u011fi\u015fiklik g\u00f6sterir. Tedavinizle ilgili kararlar almadan \u00f6nce her zaman kendi nefrolo\u011funuza veya nakil merkezinize dan\u0131\u015f\u0131n.<\/p>\n  <\/div>\n\n  <div class=\"kaynak\">\n    <h3>Kaynak\u00e7a<\/h3>\n    <ol>\n      <li>Abecassis M, Bartlett ST, Collins AJ, ve ark. Son d\u00f6nem b\u00f6brek hastal\u0131\u011f\u0131 i\u00e7in birincil tedavi olarak b\u00f6brek nakli: Ulusal B\u00f6brek Vakf\u0131 \/ B\u00f6brek Hastal\u0131\u011f\u0131 Sonu\u00e7lar\u0131 Kalite Giri\u015fimi (NKF\/KDOQI) konferans\u0131.\n        <i>Clin J Am Soc Nephrol<\/i> 2008;3:471\u201380.<\/li>\n      <li>Mange KC, Joffe MM, Feldman HI. Uzun s\u00fcreli diyaliz kullan\u0131m\u0131n\u0131n veya kullan\u0131lmamas\u0131n\u0131n canl\u0131 vericilerden al\u0131nan b\u00f6brek nakillerinin sonraki sa\u011fkal\u0131m\u0131 \u00fczerindeki etkisi.\n        <i>N Engl J Med<\/i> 2001;344:726\u201331.<\/li>\n      <li>Innocenti GR, Wadei HM, Prieto M, ve di\u011ferleri. Preemptif canl\u0131 vericili b\u00f6brek nakli: Faydalar\u0131 t\u00fcm al\u0131c\u0131lara uzan\u0131yor mu?\n        <i>Nakil<\/i> 2007;83:144\u20139.<\/li>\n      <li>Davis CL. \u00d6nleyici nakil ve \u00f6nce nakil giri\u015fimi.\n        <i>Curr Opin Nephrol Hypertens<\/i> 2010.<\/li>\n      <li>OPTN Az\u0131nl\u0131k \u0130\u015fleri Komitesi. B\u00f6brek nakli i\u00e7in hasta sevkinde e\u011fitimsel rehberlik, 2015.<\/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 The best transplant is the one that happens before dialysis. Every month on dialysis costs you something the transplant cannot give back. Done early enough, a transplant can mean no dialysis at all \u2014 and a realistic chance of returning to your old job. Written by Prof. Dr. Murat [&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-2932","post","type-post","status-publish","format-standard","hentry","category-kidney-transplant-guide"],"_links":{"self":[{"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts\/2932","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=2932"}],"version-history":[{"count":4,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts\/2932\/revisions"}],"predecessor-version":[{"id":2937,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts\/2932\/revisions\/2937"}],"wp:attachment":[{"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/media?parent=2932"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/categories?post=2932"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/tags?post=2932"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}