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Leukapheresis for inflammatory bowel disease

Guidance issued Guidance issued
 
IP Guidance Number: IPG126
 
Summary:

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on leukapheresis for inflammatory bowel disease.

Description:

Ulcerative colitis and Crohn’s disease are the most common forms of inflammatory bowel disease. Ulcerative colitis causes inflammation and ulceration of the rectum and sometimes the colon. Symptoms include bloody diarrhoea and rectal bleeding. Crohn’s disease usually causes inflammation and ulceration of the small and large intestines, but it can affect any part of the digestive tract. The main symptoms are abdominal pain, diarrhoea and weight loss. Both of these are chronic conditions, characterised by periods of clinical relapse and remission.

Conservative treatments include dietary measures, and medications to control inflammation. Immunosuppressants may be used if other medical therapies are ineffective at maintaining remission. Patients with ulcerative colitis that does not respond to medical therapy may be treated with surgery to remove the colon. Although surgery may also be used for patients with Crohn’s disease, it may not be curative and the disease often recurs in a different part of the digestive tract.

Leukapheresis involves extracorporeal removal of leukocytes from the blood, either by centrifugation or by passage of blood through an adsorptive system. In each system, venous blood is removed in a continuous flow, anticoagulated, processed to deplete the leukocytes, and returned to the circulation. A leukapheresis session takes approximately one to two hours. The procedure is usually carried out once or twice a week, for about 5 to 10 sessions.

Arrangements:

Other (see guidance)

Topic Area:

Digestive system

Specialty:

Gastro-enterology

Specialist advice has
been sought from:
British Society of Gastroenterology
Date notified to NICE: 01 May 2003
Provisional Consultation Date: February 2005
Guidance Publication Date: 22 June 2005
Contact Details:
Project Manager
(for general enquiries or comments)
Ben Doak
Technical Lead
(for procedure specific enquiries or comments)
Helen Gallo
ip@nice.org.uk
Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA


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