Red Cell Disorders Unit
In response to a perceived local need, in 1990 Dr Walker set up a unique specialist, consultant-based clinic for patients affected by inherited abnormalities of haemoglobin, especially Thalassaemia and Sickle Cell syndromes.
This has resulted in an active programme of clinical research and service provision with the world’s first cardiology clinic set up specifically to provide a diagnostic and treatment service for these young patients with these challenging conditions.
In co-operation with Dudley Pennell, from the Brompton Hospital, the clinic developed the now accepted methodology of measuring myocardial iron content using magnetic resonance imaging (cMR T2*); it also undertook the first randomised placebo controlled treatment trial in thalassaemia. These efforts have been credited with helping to change the outlook for these patients, with a recorded large fall in mortality in the last decade.
Dr Walker serves as a scientific consultant and adviser for the WHO sponsored International Thalassaemia association (Thalassaemia International Federation (TIF)), which has a very active programme of support, education and intensive political lobbying to improve the outlook for the hundreds of thousands of patients with the inherited condition of Thalassaemia, 80% of whom live in the poorer nations of the world.
The clinic is based at the Hatter Cardiovascular Institute and provides cardiology investigations for this group of patients, within a network of interested consultants in haematology, named the Red Cell Disorders Unit. The clinical experience and research emanating from this development has led to many publications and, most importantly, has led to protocols that have resulted in major survival improvements, for Thalassaemia patients in particular.
The clinic is expanding its remit to provide a similar model of care to the much larger population group affected by sickle cell syndromes.
Cardiology Centre for Inherited Diseases of Haemoglobin
Involvement with patients with inherited diseases of haemoglobin has led to an active programme of clinical research and service provision with the world’s first cardiology clinic set up specifically to provide a diagnostic and treatment service for these young patients with these challenging conditions: the Cardiology Centre for Inherited Diseases of Haemoglobin at the Hatter Cardiovascular Institute.
India and the countries of the Middle East
Dr Walker has regularly been involved in educational seminars for doctors, nurses and professionals allied to medicine on the topic of the heart in Thalassaemia and Sickle Cell Disease. This commitment to education has also included many seminars and lectures to patients and their families, usually organised through the auspices of Thalassaemia International Federation and UK Thalassaemia Society, amongst others. Regular teaching visits to India and many countries in the Middle East have been undertaken to promote prevention and better management of cardiovascular complications in the inherited blood disorders.
In India, Dr Walker participates in Thalassaemia clinical ‘camps’, where many dozens of affected patients and their families come great distances to receive clinical care, funded by the local Thalassaemics India charity.
Dr Walker has provided pro bono clinical services to the India Thalassaemic society, by undertaking clinics in India on an annual basis. These clinics also serve as a launching point for setting locally appropriate standards of cardiovascular investigation & care.