演讲题目：How does kidney transplant surgery work?

演讲简介：

1954年，约瑟夫·穆雷尝试了一种前所未有的肾脏交换手术。这次手术成功得益于一个关键因素：肾脏来自他的同卵双胞胎。70年后的今天，仅在美国，每年就有近10万例肾脏移植手术。那么，今天这种手术是如何进行的呢？



中英文字幕

In the 1930s, doctors began experimenting with a procedure long thought to be medically impossible: an organ transplant.

在20世纪30年代，医生们开始尝试一种长期以来被认为在医学上不可能实现的手术：器官移植。

Many pioneering surgeons focused on the kidney,

许多开创性的外科医生将重点放在肾脏上，

taking a healthy one from a living or recently deceased person and transplanting it into a patient dying from kidney failure.

他们从活人或刚去世的人身上取出一个健康的肾脏，将其移植到因肾衰竭濒临死亡的病人身上。

But these early surgeries faced a major problem:

但这些早期手术面临一个重大问题：

patients' immune systems would quickly recognize the new kidney as a foreign object and start to destroy it.

患者的免疫系统会迅速将新肾脏识别为异物，并开始破坏它。

Few patients survived past the first few days.

很少有患者能在术后存活超过几天。

Then, in 1954, Joseph Murray attempted a type of kidney swap that no doctor had tried before.

然后，在1954年，约瑟夫·默里尝试了一种此前从未有医生尝试过的肾脏交换手术。

The surgery was a success, and the patient would go on to live the next 8 years with the transplanted organ, thanks to one key factor:

手术取得了成功，患者随后带着移植的器官生活了8年，这要归功于一个关键因素：

it came from his identical twin.

移植的肾脏来自他的双胞胎兄弟。

70 years later, upwards of 100,000 kidneys are transplanted annually in the US alone.

70年后，仅在美国，每年进行的肾脏移植数量超过10万例。

So how does this surgery work today?

那么这种手术今天是如何进行的呢？

Kidneys are true workhorses— these fist-sized organs filter the equivalent of an entire bathtub's worth of blood each day.

肾脏是真正的工作站--这两个拳头大小的器官每天过滤相当于一个整个浴缸的血液量。

In addition to removing this waste and extra fluid through urine, the kidneys also regulate the production of red blood cells, vitamin D,

除了通过尿液排除废物和多余的液体外，肾脏还调节红血球、维生素D、

and other hormones.

和其他激素的产生。。

Certain medical conditions can prompt the kidneys to work overtime, leading to gradual deterioration.

某些医疗状况可能导致肾脏超负荷工作，进而导致逐渐恶化。

For example, in diabetes, higher blood sugar concentrations can trigger increased kidney filtration, swelling, and inflammation.

例如，在糖尿病中，较高的血糖浓度可能引发肾脏过滤增加、肿胀和炎症。

High blood pressure can constrict and damage the organ's delicate blood vessels.

高血压可以收缩并损害肾脏脆弱的血管。

Over time, people can lose complete function of their kidneys and must rely on a treatment called dialysis to survive.

随着时间的推移，人们可能会完全失去肾脏功能，必须依赖一种叫做透析的治疗来维持生命。

Yet dialysis is time consuming and fraught with serious medical complications.

然而，透析既费时又伴随严重的医学并发症。

A kidney transplant offers a more permanent solution with a dramatically improved quality of life.

肾脏移植提供了一种更为永久的解决方案，显著改善了生活质量。

Once a patient is approved for the surgery, the search for a suitable organ begins.

一旦患者获得手术批准，便开始寻找合适的器官供体。

Historically, the biggest barrier was finding a donor whose immune system makeup closely resembled that of the patient's, like an identical twin,

从历史上看，最大的问题是找到一个免疫系统构成与患者相似的捐献者，比如像同卵双胞胎一样，

as to reduce the risk of organ rejection.

以减少器官排斥的风险。

But today, thanks to medical advances, a patient's family member, friend, or even a stranger can donate one of their kidneys.

但今天，随着医学进步，患者的家庭成员、朋友，甚至陌生人都可以捐赠其中一只肾脏。

New drug therapies can effectively suppress a patient's immune response before and long after the transplant,

新的药物治疗可以有效抑制患者的免疫反应，在移植前和移植后很长一段时间内，

meaning that patients and donor pairs no longer must be perfect matches.

这意味着患者和捐赠者不再必须是完美匹配。

Still, the closer the match, the better.

不过，匹配越接近，效果越好。

So another option is a paired organ exchange, where two or more incompatible donor and patient pairs are matched up,

另一个选择是配对器官交换，两个或更多不兼容的捐赠者和患者配对被重新匹配，

allowing each patient to receive a more compatible kidney from the other pair.

使每个患者能够从另一个配对中接受更兼容的肾脏。

Once an organ is found, the surgery itself is straightforward.

一旦找到器官，手术本身就很简单。

First, the living donor's kidney is removed using minimally invasive and often robotic techniques.

首先，使用微创且通常是机器人技术切除活体捐赠者的肾脏。

As for the transplant patient, an incision is made in their lower abdomen and the donor organ is implanted.

至于接受移植的患者，会在其下腹部做一个切口，然后将捐赠的肾脏植入。

The new kidney's artery and vein are connected to the recipient's to create blood flow, and its ureter is attached to the patient's bladder.

新肾脏的动脉和静脉与接受者的血管连接，以确保血液流动，同时其输尿管与患者的膀胱连接。

The failed kidneys are typically left in place, allowing them to continue to aid in filtration.

衰竭的肾脏通常会留在原处，使它们能够继续帮助过滤。

After surgery, a patient is closely monitored for the next several days to ensure the new kidney starts filtering their blood,

手术后，患者将在接下来的几天内接受密切监测，以确保新肾脏开始过滤患者的血液，

and subsequently producing urine on its own.

并随后自行产生尿液。

This new kidney typically lasts between 12 to 20 years.

这颗新肾脏通常可以维持12到20年。

Some people will have multiple kidney transplants in their lifetime, meaning at some point they may have four or even five kidneys in their bodies.

一些人在一生中会接受多次肾脏移植，这意味着在某些时候，体内可能会有四个甚至五个肾脏。

As for donors, most leave the hospital the next day, and can resume normal activity within a few weeks.

至于捐赠者，大多数人在第二天就能出院，并且在几周内可以恢复正常活动。

While all surgeries carry risks, most donors go on to lead normal, healthy lives,

虽然所有手术都有风险，但大多数捐赠者会继续过上正常、健康的生活，

facing no, or relatively few, complications related to living with a single kidney.

几乎没有或只有很少的有并发症，与单肾生活相关。

But not all patients will have a willing living donor.

但并不是所有患者都有愿意的活体捐赠者。

In the US alone, around 90,000 patients sit on the national waiting list to be matched with a kidney from a deceased donor.

仅在美国，大约有90,000名患者在全国等待名单上，等待与一位已故捐赠者的肾脏匹配。

While many people register as organ donors, only 0.3% will lose their lives in circumstances that allow for organ donation.

虽然许多人登记为器官捐赠者，但只有0.3%的人会在允许器官捐赠的情况下丧生。

Due to this organ shortage, about 17 patients die every day waiting for a new kidney.

由于器官短缺，约有17名患者每天在等待新肾脏的过程中去世。

Thankfully, doctors continue to push against the limits of what's possible,

值得庆幸的是，医生们不断突破可能的极限，

exploring new treatments and the potential of lab-grown, 3D printed, and even artificial kidneys.

探索新的治疗方法，以及实验室培养、 3D打印，甚至人工肾脏的潜力。

本文来自公众微信号：听歌学英语