Transfusion Alternatives Pre-operatively in Sickle Cell Disease (TAPS) (TAPS)
Transfusion Alternatives Pre-operatively in Sickle Cell Disease
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Moira Malfroy, BS (Hons),RN
- Phone Number: 01223 548169
- Email: moira.malfroy@nbs.nhs.uk
Study Contact Backup
- Name: Charlotte Llewelyn, PhD
- Phone Number: 01223 548047
- Email: charlotte.llewelyn@nbs.nhs.uk
Study Locations
-
-
Cambridgeshire
-
Cambridge, Cambridgeshire, United Kingdom, CB2 2PT
- NBS/MRC Clinical Studies Unit, National Blood Service
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Sickle cell disease, either Hb SS or Hb SB0 thal, confirmed by Hb electrophoresis, Deoxyribonucleic Acid (DNA) analysis or High Performance Liquid Chromatography (HPLC)
- At least 24 hourse and no more than 14 days before surgery and a date for surgery has been given
- Surgery to be low or medium risk
- Surgery to be with general or regional anaesthesia
- Written informed consent from patient/parent/guardian is given
- More than six months since previous TAPS trial surgery.
Exclusion Criteria:
- Having a procedure involving intravascular contrast radiography or an imaging procedure
- On a regular blood transfusion regime
- Had a blood transfusion within the last three months
- The planned procedure involves local anaesthetic only
- Haemoglobin level at randomisation less than 6.5g/dL
- Children with a clinical history of stroke (history of silent infarcts would not preclude randomisation)
- Acute chest syndrome within the last six months, or patient has ever required intubation and mechanical ventilation for treatment of acute chest syndrome
- Oxygen saturation at randomisation less than 90%
- Patient is on renal dialysis
- Already entered twice into the TAPS trial
- The physician is unwilling to randomise the patient (such patients will be entered into a trial log).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: A
Patients will not receive a pre-operative transfusion.
|
Pre-operative red blood cell transfusion
|
|
Active Comparator: B
Patients will receive a pre-operative blood transfusion.
Those presenting with an admission Hb of less than 9g/dL will receive a simple (also called a 'top-up') transfusion, those presenting with an admission Hb of more than or equal to 9g/dL will undergo a partial exchange transfusion.
|
Pre-operative red blood cell transfusion
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
The frequency of all clinically significant complications in sickle Cell patients (Hb SS or SB0 thal) undergoing low or medium risk planned surgery.
Time Frame: Between randomisation and 30 days post surgery, inclusive.
|
Between randomisation and 30 days post surgery, inclusive.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
1. Complications included in the primary outcome, plus red cell alloimmunisation.
Time Frame: Up to 3 months post surgery.
|
Up to 3 months post surgery.
|
|
2. Total days in hospital, to include hours/days spent having pre-operative transfusion, days on intensive care and high dependency units, and other wards.
Time Frame: Up to 30 days post surgery, inclusive.
|
Up to 30 days post surgery, inclusive.
|
|
3. Re-admission or failure to discharge.
Time Frame: Up to 30 days post surgery.
|
Up to 30 days post surgery.
|
|
Number of red cell units received.
Time Frame: Intra and post-operatively.
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Intra and post-operatively.
|
|
Health economic analysis: differential health service costs of routine transfusion relative to control, plus quality adjusted survival and treatment cost-effectiveness and benefits in QOL years.
Time Frame: Up to 30 days post surgery.
|
Up to 30 days post surgery.
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Lorna M Williamson, MRCP,MRCPath, University of Cambridge and NHSBT
- Study Chair: Sally C Davies, MRCP,MRCPath, Imperial College, University of London and Central Middlesex Hospital
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- BS02/4/RB31
- ISRCTN:00862331
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