{"id":2941,"date":"2026-09-06T18:17:33","date_gmt":"2026-09-06T18:17:33","guid":{"rendered":"https:\/\/bookinghospital.org\/?p=2941"},"modified":"2026-09-06T18:23:48","modified_gmt":"2026-09-06T18:23:48","slug":"who-cannot-have-a-kidney-transplant","status":"publish","type":"post","link":"https:\/\/bookinghospital.org\/tr\/kimler-bobrek-nakli-olamaz\/","title":{"rendered":"B\u00f6brek Nakli Kimlere Yap\u0131lamaz"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"2941\" class=\"elementor elementor-2941\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ae63ddf e-con-full e-flex e-con e-parent\" data-id=\"ae63ddf\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4728799 elementor-widget elementor-widget-html\" data-id=\"4728799\" 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>Ger\u00e7ekten b\u00f6brek nakli olamayacak durumdakiler kimlerdir?<\/h1>\n    <p class=\"lead\">Hastalar\u0131n ald\u0131\u011f\u0131 redlerin \u00e7o\u011fu bu listede de\u011fildir. Ger\u00e7ek engellerin ne oldu\u011funu ve hangilerinin kal\u0131c\u0131 oldu\u011funu bilmekta fayda var.<\/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>Listesi <b>mutlak engeller k\u0131sad\u0131r<\/b>, ve hastalar\u0131n endi\u015fe etti\u011fi durumlar\u0131n \u00e7o\u011fu bu listede yer almamaktad\u0131r.<\/li>\n      <li>Listedeki neredeyse her \u00f6\u011fe bir \u015feyi tan\u0131mlar <b>aktif veya \u00e7\u00f6z\u00fclmemi\u015f<\/b> \u2014\n          ki bu da genellikle de\u011fi\u015febilece\u011fi anlam\u0131na gelir.<\/li>\n      <li><b>HIV g\u00f6receli bir kontrendikasyondur<\/b>, kesin de\u011fil. Belirlenen kriterler mevcuttur ve bunlar\u0131 kar\u015f\u0131layan hastalar nakledilir.<\/li>\n      <li><b>Kanser vakaya g\u00f6re de\u011ferlendirilir<\/b>, t\u00fcm\u00f6r tipine ve tedavi sonras\u0131ndaki s\u00fcrece g\u00f6re.<\/li>\n      <li>Listedeki bir \u00f6\u011fe hi\u00e7 t\u0131bbi de\u011fil ve kesinlikle plan yapmaya de\u011fer olan da o.<\/li>\n    <\/ul>\n  <\/div>\n\n  <h2>Kesin kontrendikasyonlar<\/h2>\n\n  <p>Bunlar, var olduklar\u0131 s\u00fcrece b\u00f6brek naklini ger\u00e7ekten ortadan kald\u0131ran durumlard\u0131r:<\/p>\n\n  <div class=\"tblwrap\">\n    <table>\n      <thead>\n        <tr><th>\u015eart<\/th><th>Kal\u0131c\u0131 m\u0131?<\/th><\/tr>\n      <\/thead>\n      <tbody>\n        <tr><td>\u00c7\u00f6z\u00fclememi\u015f kanser<\/td><td>Hay\u0131r \u2014 tedaviye ve remisyona ba\u011fl\u0131d\u0131r<\/td><\/tr>\n        <tr><td>Aktif A\u0130DS veya aktif hepatit<\/td><td>Hay\u0131r \u2014 hastal\u0131\u011f\u0131n kontrol alt\u0131nda olup olmad\u0131\u011f\u0131na ba\u011fl\u0131d\u0131r<\/td><\/tr>\n        <tr><td>Aktif t\u00fcberk\u00fcloz<\/td><td>Hay\u0131r \u2014 tedavi edilebilir<\/td><\/tr>\n        <tr><td>\u015eiddetli damar hastal\u0131\u011f\u0131<\/td><td>Genellikle evet<\/td><\/tr>\n        <tr><td>Aktif intraven\u00f6z uyu\u015fturucu ba\u011f\u0131ml\u0131l\u0131\u011f\u0131<\/td><td>Hay\u0131r \u2014 iyile\u015fmeye ba\u011fl\u0131<\/td><\/tr>\n        <tr><td>Be\u015f ya\u015f alt\u0131 ya\u015fam beklentisi<\/td><td>Temel nedenine ba\u011fl\u0131<\/td><\/tr>\n        <tr><td>Son miyokard infarkt\u00fcs\u00fc<\/td><td>Hay\u0131r \u2014 bir zamanlama meselesi<\/td><\/tr>\n        <tr><td>Di\u011fer son d\u00f6nem organ yetmezli\u011fi (kalp, akci\u011fer, karaci\u011fer)<\/td><td>Kombine nakle y\u00f6nlendirilebilir<\/td><\/tr>\n        <tr><td><b>Nakil sonras\u0131 ilac\u0131 kar\u015f\u0131layamama durumu<\/b><\/td><td>Hay\u0131r \u2014 ancak ameliyattan \u00f6nce \u00e7\u00f6z\u00fclmesi gerekiyor<\/td><\/tr>\n      <\/tbody>\n    <\/table>\n  <\/div>\n\n  <div class=\"box\">\n    <span class=\"etiket\">\u0130kinci s\u00fctunu oku<\/span>\n    <p>Bunlar\u0131n \u00e7o\u011fu \u015fu \u015fekilde yaz\u0131lm\u0131\u015ft\u0131r: <b>\"aktif\"<\/b>, <b>\"\u00e7\u00f6z\u00fclmemi\u015f\"<\/b>, <b>\"son\"<\/b>. Bu ifade kas\u0131tl\u0131d\u0131r. Hastan\u0131n kal\u0131c\u0131 bir \u00f6zelli\u011fini de\u011fil, belirli bir andaki durumunu tan\u0131mlarlar.<\/p>\n    <p>Sona erebilen bir kontrendikasyon <b>gecikme<\/b>, bir reddetme de\u011fil \u2014 ve bu ikisi ayn\u0131 c\u00fcmlede bildirilmemelidir.<\/p>\n  <\/div>\n\n  <div class=\"soru\">\n    <h3>Listedeki son \u00f6\u011fe<\/h3>\n\n    <p>Bir giri\u015f hastal\u0131k de\u011fildir: <b>hastan\u0131n nakil sonras\u0131nda ilac\u0131n\u0131 temin edememesi.<\/b><\/p>\n\n    <p>Zor bir sebepten \u00f6t\u00fcr\u00fc listede yer al\u0131yor. Ba\u011f\u0131\u015f\u0131kl\u0131k sistemini bask\u0131layan ila\u00e7lar iste\u011fe ba\u011fl\u0131 de\u011fildir ve ge\u00e7ici de\u011fildir. Al\u0131c\u0131s\u0131n\u0131n kullanmay\u0131 b\u0131rakaca\u011f\u0131 nakledilmi\u015f bir b\u00f6brek kaybedilecektir \u2014 ve ba\u011f\u0131\u015flanan bir organ, vericinin ameliyat\u0131yla birlikte bo\u015fa gitmi\u015f olacakt\u0131r.<\/p>\n\n    <p>Bu, mali s\u0131k\u0131nt\u0131y\u0131 nakil ekibinden saklamak i\u00e7in bir neden de\u011fildir. Bu, etraf\u0131nda h\u00e2l\u00e2 planlama yap\u0131labilecekken, durumu erken dile getirmek i\u00e7in bir nedendir. Ekipler bunu ameliyattan sonra \u00f6\u011frenmektense ameliyattan \u00f6nce \u00e7\u00f6zmeyi defalarca tercih ederler.<\/p>\n  <\/div>\n\n  <h2>HIV: g\u00f6receli bir kontrendikasyon<\/h2>\n\n  <p>HIV pozitifli\u011fi bir <b>akraba<\/b> kontrendikasyon, mutlak bir kontrendikasyon de\u011fil. Baz\u0131 HIV pozitif hastalar, canl\u0131 veya kadavra vericiden b\u00f6brek nakli i\u00e7in uygundur.<\/p>\n\n  <p>Yay\u0131nlanm\u0131\u015f fikir birli\u011fi kriterleri, neyin do\u011fru olmas\u0131 gerekti\u011fini ortaya koymaktad\u0131r:<\/p>\n\n  <ul>\n    <li><b>200\/mm\u00b3 \u00fczerindeki CD4+ T h\u00fccre say\u0131s\u0131<\/b> alt\u0131 aydan uzun s\u00fcredir<\/li>\n    <li><b>HIV-1 RNA saptanamad\u0131<\/b> \u00fc\u00e7 aydan fazla bir s\u00fcredir<\/li>\n    <li>Tarih: <b>y\u00fcksek aktif antiretroviral tedavi<\/b> \u00fc\u00e7 aydan fazla bir s\u00fcredir<\/li>\n    <li><b>F\u0131rsat\u00e7\u0131 enfeksiyonlardan ar\u0131nm\u0131\u015f<\/b><\/li>\n  <\/ul>\n\n  <p>Spesifik test gereksinimleri ve bunlar\u0131n zamanlamas\u0131, nakil ekibi ve bula\u015f\u0131c\u0131 hastal\u0131klar ekibi taraf\u0131ndan ortakla\u015fa planlan\u0131r. Yukar\u0131daki listedeki ayr\u0131m\u0131na dikkat edin: <b>aktif AIDS<\/b> mutlak bir bariyerdir. Kontroll\u00fc HIV enfeksiyonu ayn\u0131 \u015fey de\u011fildir.<\/p>\n\n  <h2>Kanser: Vakaya g\u00f6re de\u011ferlendirilir<\/h2>\n\n  <p>Bir nakil aday\u0131nda kanser bulundu\u011funda temkinli olmak i\u00e7in iki hakl\u0131 neden vard\u0131r:<\/p>\n\n  <ol>\n    <li>Transplantasyondan sonra verilen imm\u00fcns\u00fcpresif tedavi <b>do\u011fal ak\u0131\u015f\u0131n\u0131 olumsuz etkiler<\/b> kanserden.<\/li>\n    <li>Nakil <b>ya\u015fam beklentisi zaten k\u0131sa olan bir hasta i\u00e7in uygun de\u011fil<\/b> kanser t\u00fcr\u00fcn\u00fcn kendisi y\u00fcz\u00fcnden.<\/li>\n  <\/ol>\n\n  <p>Ancak bunlar\u0131n hi\u00e7biri kanseri otomatik bir elenme sebebi yapmaz.<\/p>\n\n  <div class=\"box\">\n    <span class=\"etiket\">Asl\u0131nda nas\u0131l karar veriliyor<\/span>\n    <p>Kanser \u00f6yk\u00fcs\u00fc <b>kesin bir engel te\u015fkil etmez<\/b> nakline. Her hasta, ayr\u0131 ayr\u0131, g\u00f6re de\u011ferlendirilir <b>t\u00fcm\u00f6r t\u00fcr\u00fc<\/b> ve\n      <b>t\u00fcm\u00f6rs\u00fcz bekleme s\u00fcresi<\/b> tedavi beri.<\/p>\n    <p>Farkl\u0131 kanser t\u00fcrleri, farkl\u0131 bekleme s\u00fcreleri gerektirir. \"Kanser ge\u00e7irdiniz\" bir cevap de\u011fildir; sorular \u015funlard\u0131r: hangisi ve ne kadar s\u00fcre \u00f6nce?.<\/p>\n  <\/div>\n\n  <h2>Listede ne yok<\/h2>\n\n  <p>Hastalar\u0131n s\u0131kl\u0131kla elenecekleri s\u00f6ylenen, ancak kesin kontrendikasyonlar aras\u0131nda yer almayan durumlar\u0131 adland\u0131rmakta fayda vard\u0131r:<\/p>\n\n  <ul>\n    <li><b>Diyabet<\/b> \u2014 \u015feker hastal\u0131\u011f\u0131 hastalar\u0131 nakilden en \u00e7ok fayda g\u00f6rebilir<\/li>\n    <li><b>Hepatit B veya C<\/b> \u2014 karaci\u011fer sirotik olmad\u0131k\u00e7a bir engel de\u011fil<\/li>\n    <li><b>Ya\u015f<\/b> \u2014 \u00e7o\u011fu merkez \u00fcst s\u0131n\u0131r belirlemez; ya\u015fa de\u011fil, uygunlu\u011fa bak\u0131l\u0131r<\/li>\n    <li><b>Kilolu veya zay\u0131f olma<\/b> \u2014 kiloyu d\u00fczeltmek i\u00e7in bir neden, reddetmek i\u00e7in de\u011fil<\/li>\n    <li><b>Daha \u00f6nce ba\u015far\u0131s\u0131z olmu\u015f bir nakil<\/b> \u2014 yeniden nakil rutin bir i\u015flemdir<\/li>\n    <li><b>Yetersiz doku uyumu<\/b> \u2014 canl\u0131 verici s\u00f6z konusu oldu\u011funda b\u00fcy\u00fck \u00f6l\u00e7\u00fcde alakas\u0131zd\u0131r<\/li>\n    <li><b>Uyumsuz kan grubu<\/b> \u2014 e\u015fle\u015ftirilmi\u015f de\u011fi\u015fasama ve ABO uyumsuz yollar mevcuttur<\/li>\n    <li><b>Pozitif \u00e7apraz kar\u015f\u0131la\u015ft\u0131rma<\/b> \u2014 antikor t\u00fcr\u00fcne ba\u011fl\u0131d\u0131r<\/li>\n  <\/ul>\n\n  <p>Bunlar\u0131n her biri hastalar\u0131 geri g\u00f6ndermek i\u00e7in kullan\u0131lm\u0131\u015ft\u0131r. Hi\u00e7biri bu sayfan\u0131n tepesindeki listede yer alm\u0131yor.<\/p>\n\n  <h2>E\u011fer reddedildiyseniz<\/h2>\n\n  <p>\u00dc\u00e7 soru, belirsiz bir reddedi\u015fi \u00fczerinde i\u015flem yapabilece\u011finiz bir \u015feye d\u00f6n\u00fc\u015ft\u00fcr\u00fcr:<\/p>\n\n  <ul>\n    <li><b>Hangi spesifik bulgu nedendi?<\/b> \"Sizin durumunuz\" de\u011fil \u2014 bulgu.<\/li>\n    <li><b>Kesin listede mi, yoksa bir gecikme mi?<\/b> Fark her \u015feydir.<\/li>\n    <li><b>E\u011fer bu bir gecikme ise, neyin de\u011fi\u015fmesi gerekir ve ne kadar?<\/b> \u00dczerinde \u00e7al\u0131\u015fabilece\u011finiz bir say\u0131 bir pland\u0131r. Belirsiz bir cevap genellikle de\u011fildir.<\/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>Reddiniz listede miydi?<\/h2>\n    <p>Bize raporlar\u0131 ve size verilen gerek\u00e7eyi g\u00f6nderin. Cevap reddin ge\u00e7erli oldu\u011fu durumu kapsasa bile, hangisinin do\u011fru oldu\u011funu size d\u00fcr\u00fcst\u00e7e s\u00f6yleyece\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\u0131mlanm\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 tutamaz. Kontrendikasyon kriterleri merkezler aras\u0131nda farkl\u0131l\u0131k g\u00f6sterir ve tedaviler ilerledik\u00e7e de\u011fi\u015fir. Tedaviniz hakk\u0131nda karar vermeden \u00f6nce her zaman kendi nefroloji uzman\u0131n\u0131za veya nakil merkezinize dan\u0131\u015f\u0131n.<\/p>\n  <\/div>\n\n  <div class=\"kaynak\">\n    <h3>Kaynak\u00e7a<\/h3>\n    <ol>\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      <li>Kasiske BL, Cangro CB, Hariharan S ve ark. B\u00f6brek nakli adaylar\u0131n\u0131n de\u011ferlendirilmesi: klinik uygulama k\u0131lavuzlar\u0131.\n        <i>Am J Transplant<\/i> 2001;1(ek 2):3\u201395.<\/li>\n      <li>Rao PS, Merion RM, Ashby VB, Port FK, Wolfe RA, Kayler LK. 70 ya\u015f \u00fcst\u00fc ya\u015fl\u0131 hastalarda b\u00f6brek nakli: Organ Nakli Al\u0131c\u0131lar\u0131 Bilimsel Kay\u0131tlar\u0131'ndan sonu\u00e7lar. <i>Nakil<\/i> 2007;83:1069\u201374.<\/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 Who genuinely cannot have a kidney transplant? Most refusals patients receive are not on this list. It is worth knowing what the real barriers are \u2014 and which of them are permanent. Written by Prof. Dr. Murat Tuncer \u00b7 Adapted from his book Kidney Transplantation \u2014 With Questions and [&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-2941","post","type-post","status-publish","format-standard","hentry","category-kidney-transplant-guide"],"_links":{"self":[{"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts\/2941","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=2941"}],"version-history":[{"count":4,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts\/2941\/revisions"}],"predecessor-version":[{"id":2946,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/posts\/2941\/revisions\/2946"}],"wp:attachment":[{"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/media?parent=2941"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/categories?post=2941"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bookinghospital.org\/tr\/wp-json\/wp\/v2\/tags?post=2941"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}