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VOL. 132 | NO. 103 | Wednesday, May 24, 2017

UTHSC's Center for Bleeding Disorders Growing

MICHAEL WADDELL, Special to The Daily News

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The University of Tennessee Health Science Center stepped up a little more than a year ago to provide a special clinic for bleeding disorders, but has now turned that into a comprehensive center that provides life-changing treatment for those in the Mid-South afflicted with these disorders.

Dr. Sandeep Rajan, medical director of the Hemophilia and Thrombosis Treatment Center established in East Memphis by University of Tennessee Health Science Center. (Submitted)

UTHSC’s College of Medicine established the Hemophilia and Thrombosis Treatment Center at 6401 Poplar Ave. in East Memphis. It is one of only 120 comprehensive clinics in the country and the only one within a 150-mile radius of Memphis.

The clinic has grown gradually, with hematology and primary physician and infusion services launching in March of last year. The multi-team, comprehensive care started last month.

“All of this was previously set up in Regional One Medical Center,” said Dr. Sandeep Rajan, the center’s medical director. “However, as the city evolved many of our patients were living out east, and they were not able to get help from the center located Downtown. Now we have everything under one roof, and they know who to call.”

The new center balances the commute distance for most people living in Memphis and the surrounding area.

“Many hemophiliacs have joint problems, so having to park at a distance or board a shuttle is a big problem,” said Rajan, who came to work at UTHSC three years ago. “Here they can get parked right at the front and get ushered in, so it’s a much easier commute for them.”

Rajan estimates that 750 to 800 people in the area suffer from bleeding disorders of one form or another. Roughly 350 to 400, mostly males, are hemophiliacs whose blood has a reduced ability to clot. The rest are those with common and rare conditions, including anemia, thalassemia (abnormal formulation of hemoglobin), and thrombosis (increased tendency toward clotting).

The clinic also treats patients with Hepatitis C, platelet disorders, abnormal proliferation of blood cells in the bone marrow, abnormal iron metabolism, and women’s health issues, such as excessive bleeding and clotting.

“Since we were located previously in a multi-disciplinary clinic, turnaround time for certain things was too long,” explained Rajan. “If you ordered a blood test it would take one hour to get drawn and another hour to come back. Here, by making it a smaller ship, we have more efficiency. People get checked in faster, and they get their blood tests done faster.”

A sample is prepared for blood disorder research at UTHSC. (Submitted)

The comprehensive clinic offers a full range of services, including hematology physician services, nursing, case management and social work, infusion therapy, physical therapy, dentistry, pharmaceutical services, and it also has a laboratory and primary care physicians who treat routine health needs and collaborate with specialists.

“Physical therapy is very important in hemophilia and other bleeding disorders because I treat them with something to fix the bleeding,” Rajan says, “but they need to exercise to strengthen their joints and get the appropriate walking frames and evaluation for gait to be more mobile and more independent.”

The center demonstrates the commitment of the College of Medicine and University Clinical Health to bringing expertise in areas of need to the region, said Dr. David Stern, UTHSC Robert J. Kaplan Executive Dean of the College of Medicine.

“At this time in the field of hematology/oncology, most of the physicians in practice have become medical oncologists because of the volume of cancer patients,” Stern said. “Many fewer become specialists in blood clotting disorders. It is this type of situation where the university needs to step in and provide expertise.

“Dr. Rajan is a recognized expert in coagulation disorders nationally and the go-to person sought out by physicians and patients for these disorders in West Tennessee.”

The human body’s blood coagulation system includes platelets, clotting factors and blood vessels. Maintaining the fluidity of blood within blood vessels, but rapidly inducing clotting when blood leaks outside a blood vessel (bleeding) can become very complex.

“In pathologic states, blood clotting can occur inside a blood vessel (usually a diseased blood vessel with an abnormal wall), and this prevents blood flow to the organ and causes ischemia, as in venous thrombosis in the lower extremity, a heart attack or stroke,” Stern said.

Abnormal clotting is called thrombosis and there are many causes. Although some causes of thrombosis are relatively rare (genetically determined disorders), there are multiple settings where people who are apparently “normal” develop thrombosis because of a series of coinciding risk factors.

Another type of pathologic state is when excessive bleeding occurs. This can be due to inherited bleeding disorders, such as the hemophilias, or acquired bleeding disorders that come to light in stressful situations.

The past few years have seen several breakthroughs in the treatment of hemophilia.

“This is a very exciting time for hemophilia because if you look back at the last five years there have been about 15 new drugs – a huge number compared to the past several decades,” Rajan said. “The new thing we’re working on is gene therapy, which gives us an edge to change the protein that is missing. Hopefully that could go for a cure, so we are evolving trials for that, too.”

Working to educate the next generation of health care providers to recognize these disorders and properly treat them is another primary focus of the center. Advanced videoconferencing technology allows the staff to communicate with other doctors in the city as well as around the world, and during the next academic year the center will take on a fellowship for hemophilia, one of the only of its kind in the country.

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