Nice way of working

A new red cell exchange programme is benefitting the lives of young sickle cell patients and the Leeds Therapeutic Apheresis Services (TAS) team explain how it has helped children in the area.

Back in March 2016, Abby Wilson, Lead Nurse for TAS in Leeds, read the updated NICE (National Institute for Clinical Excellence) guidelines which recommended using the Spectra Optia multi-purpose apheresis technology to treat patients with Sickle Cell Disease (SCD).

Abby approached the team at Leeds General Infirmary (LGI) to look at how the two teams could work together corroboratively to follow the NICE guidance. They identified that approximately 90 children in the region had SCD, many of whom receive top-up transfusions and would benefit from the new technology.

Of the 90 children, four were identified as being at ‘high risk’ of stroke and started immediately on the Spectra Optia Automated Red Cell Exchange (RCE) programme. The TAS team worked closely with the LGI clinic to reduce the percentage of Haemoglobin S, preventing and reducing iron overload – a complication of manual transfusions. NICE have also issued a ‘do not do’ recommendation with regard to the use of manual top up transfusion.

There are now nine children on the regular programme and it is anticipated that this number will increase in the future. Abby said “Implementing the paediatric red cell exchange service has been a really positive experience for the teams involved and the patients/ families.

 

 

 

 

 

 

 

 

 

“Everyone has worked hard to introduce the new service and I cannot thank everyone enough for their efforts. We will continue to look at ways to improve the service to provide as much as a positive experience for the patient as possible.“

This was a new and exciting challenge for the TAS and paediatric teams which has reduced the number of hospital appointments and blood products for the patient and, most importantly, improved the children’s overall quality of life.

The team now regularly attend the children’s hospital to treat patients in a clinic environment, as well as working closely with the team at LGI.

The RCE programme reduces the amount of transfusions SCD patients have (around six-eight weeks) and the time it takes. Not using the Spectra Optia may mean that patients will have to return for manual transfusion every three weeks, which can last up to four hours and can cause iron overload in patients.

The Spectra Optia separates blood into different components. Specific components, in this case the red cells, can then be removed and replaced. Fresh donors’ red cells are used to replace the patient’s red cells over the course of the two hour procedure.


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