Transfusion Alternatives Pre-operatively in Sickle-cell disease (TAPS) randomised controlled trial
Do sickle cell patients benefit from having a pre-operative transfusion or not?
What was this study about?
Sickle-cell disease (SCD) is an inherited blood disorder that affects the red blood cells. People with SCD have routinely been given a blood transfusion before they have surgery in some hospitals in the belief that this would help recovery afterwards. But the blood transfusion itself may carry some risks. Evidence from observing hospital practice is now showing that many patients are not having a blood transfusion before they have an operation, and they appear to do as well as patients who do have a transfusion. So we needed a large randomised controlled trial to test whether or not people with SCD need a blood transfusion before surgery. Knowing the answer to this question will help doctors to treat sickle cell patients better in the future.
People who took part in this trial were randomised into one of two groups. One group were given a blood transfusion before they have an operation. The other group were not. Researchers then compared what happens to these two groups of people.
What difference did this study make?
The TAPS trial found that it was beneficial to give patients with sickle cell disease a blood transfusion before they have an operation.
These results have influenced practice. They have resulted in changes to the British Committee for Standards in haematology guidelines for patients with sickle cell disease, and also to American guidelines for the pre-operative treatment of these patients. The recommendation to give patients with sickle cell disease a blood transfusion before they have an operation will benefit patients as it will mean they are less likely to develop a serious post-operative complication known as "acute chest syndrome", which causes difficulties with breathing.
Type of study
Who funded the study?
The National Blood Service, part of NHS Blood and Transplant.
When did it take place?
Recruitment opened in June 2007 and closed in March 2011.
Where did it take place?
Approximately 15 hospitals in the UK.
Who was included?
We aimed to recruit 400 people with sickle cell disease (type Hb SS and Sßo thal) aged one year and upwards who were about to have a planned operation (elective surgery) which was low or medium risk.