From Sri Lanka to Royal Brompton Hospital; the research journey of a haematologist
Dr Deepa Arachchillage’s route into research was unconventional, from training as a doctor in Sri Lanka to becoming a principal investigator for her own research project at Royal Brompton Hospital.
Dr Arachchillage is a consultant haematologist at the Trust and Imperial College Healthcare NHS trust. She is also an honorary senior lecturer at Imperial College London. Deepa is involved in providing care for patients encompassing clinical and laboratory practice.
As a consultant haematologist, Deepa works closely with the different clinical specialists within the Trust by providing clinical advice and research support related to bleeding and thrombotic disorders.
Deepa’s journey into research
Deepa graduated from North Colombo medical school in Sri Lanka and went on to complete an internship at the National Hospital Colombo, before moving to the UK in 2005.
In the UK Deepa completed her medical training, gaining experience in general medicine and haematology as a junior doctor, before entering into specialist haematology training.
It was during her specialist training in haematology that Deepa found herself becoming interested in research and quality improvement. This interest led her to apply for funding to do a research degree but was unsuccessful. Instead of giving up, she decided to write to several leading researchers across the UK looking for opportunities to work in haematology research.
Deepa says: “Research can find answers to things that are unknown, filling gaps in our knowledge and changing the way that healthcare professionals work. Our decisions on patient management should be based on evidence, and the research that we do today forms the basis of future care of our patients.”
It was at University College London that Deepa was selected to be a research fellow at the Haemostasis Research Unit. Her first project involved looking at oral anticoagulants, complement activation in patients with antiphospholipid syndrome and lupus erythematosus.
During her fellowship, Deepa was a core investigator for a study looking at anticoagulant medication rivaroxaban in comparison to warfarin in patients with antiphospholipid syndrome. She was also involved in a funding grant worth £60,000 from Lupus UK looking at activated protein C resistance in patients with antiphospholipid antibodies.
What she’s working on now
Deepa started her research journey within the Trust in 2016 by systematically reviewing data already available, including a look at the drug heparin which is used widely in the Trust.
Both heparin level and APTT (activated partial thromboplastin time) are used to monitor the anticoagulant intensity of heparin. Deepa hypothesised that APTT might not, in fact, be an accurate measure of the amount of heparin present. Using the data already available at the Trust, she was able to demonstrate that APTT was in fact not a good marker of heparin levels.
Deepa presented her findings at both national and international conferences and her results have led to a move towards the use of anti-X for monitoring of heparin. Her results have also led to protocol changes in monitoring of heparin at several hospitals both nationally and internationally.
The Trust is one of five specialist centres in England which offers ECMO, a machine that oxygenates the blood from outside the body when the lungs are unable to do so. Deepa looked retrospectively at clinical and laboratory data within the ECMO unit, soon to be published in the Journal of Seminars in Thrombosis and Hemostasis. This led to her prospective study in ECMO patients looking at the cause of bleeding and thrombotic complications, which are leading causes of morbidity and mortality in patients receiving ECMO.
In addition, she looked at the link between body weight and the dosage of anticoagulant drugs which provided useful information to clinicians in managing patients in different weight categories.
What’s next?
Deepa has several upcoming projects and will be running her own research studies as both chief investigator and principal investigator.
One such project involves a pilot study looking at investigating the coagulation markers which may be used to develop a model in predicting the risk of bleeding or thrombosis in ECMO patients.
Deepa also received a grant worth nearly £200,000 from Innovate UK in collaboration with Imperial College London to conduct a healthy volunteer study comparing various viscoelastic devices used to assess haemostasis including a new point-of-care haemostasis device which allows for tests to be carried out on the move and with low quantities of blood.
Difficulties she has faced
Deepa’s journey towards becoming a consultant haematologist has had its challenges and her attempt to enter the field of research was very difficult, partly due to the challenging research funding landscape.
Although being a woman in medicine and research has not posed any particular issues for Deepa, she did find it challenging as a non–native competing with local medics and researchers.
Continuous encouragement and support from her husband have helped Deepa achieve her goal of getting into research. Support has also come from the intensive care unit staff, Professor John Pepper and Professor Mike Laffan at Imperial College London, who helped her to continue her research activities whilst working as a full-time NHS consultant at Royal Brompton Hospital and Imperial College Healthcare NHS Trust.
How she’s helping and inspiring others
Deepa has helped to foster a budding research culture within the laboratory departments at the Trust and helped to train laboratory staff in research methodology.
She currently supervises three biomedical scientists for their MSc projects whose research was presented at the Annual AHP, HCS & Nurse Poster event held in October 2017. In addition, she has supported junior doctors on their research projects and abstract submissions to national and international meetings.
Deepa says: “I understand the difficulties of getting into research and I don’t want anybody to face the same difficulties that I did so I always want to help and encourage those interested in research in any way that I can.”
If you would like to find out more about any of the research mentioned in this article or any of our research in general, please email us at research-findoutmore@rbht.nhs.uk