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The Retention and Disposal Schedule for England provided that records had to be kept 6 years after the conclusion of treatment or 6 years after the death of a patient.

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Regional Transfusion Directors' meeting recognised that "even if the incidence had reduced significantly since the last trial, because of self exclusion or for other reasons, the introduction of anti-HBc/ALT screening seemed very likely."

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Directors of Scottish National Blood Transfusion Service agreed that the UK Working Party on Transfusion Associated Hepatitis was the most appropriate body to pursue the implementation of surrogate testing.

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Dr Gunson was a proponent of the multi-centre study of Alanine Amino-transferase (ALT) and anti-hepatitis B core (anti-HBc) for the screening of blood donations in 1986.

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At the UK Directors Working Party meeting t had been agreed that "Screening should not be introduced at present especially in view of ARC [American Red Cross] postponement of core test start-up and reports of chaos in ALT screening programme."

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Dr Forrester stated in a letter that 'The position explicitly reached at the meeting [of UK Working Party on Transfusion-Associated Hepatitis] is to recommend research of no great significance or scientific interest because the prospect of research would serve to counter pressure from for example haemophiliacs and Haemophilia Directors to embark on an indirect and largely ineffective form of screening, which would also lose us a certain amount of perfectly harmless blood.'

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Dr Contreras wrote to Dr Smithies on the decision of the UK Working Party on Transfusion-Associated Hepatitis (WPTTH) to not fund a follow-up study. She stated that WPTTH had funded surrogate studies to determine NANBH rates in donors, and Dr Contreras wanted a follow-up study, not for patient safety, but to use transmission rates as a 'defence against "panic" requests to start surrogate screening'.

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At the meeting of the regional transfusion directors, Dr Gunson explained that a study beginning with transfused patients had been discussed but was felt to be "costly, difficult and not practical."

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The Working Party on Associated Hepatitis discussed the protocol for the anti-HBc/ALT screening trials.

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At a meeting of the SNBTS directors and haemophilia centre directors, Dr Forrester reported that in the US between 5 and 25 percent of transfusions led to the recipient contracting NANBH. It was said that the figure in the UK was approximately 2.5 percent and, in Scotland, that there were only one to five cases per annum.

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Material for the PMO report, supporting the view that transfusion associated NANBH was rare, "relatively benign" and generally not serious

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Dr Forrester wrote to Dr Moir seeking agreement in principle of CSO that funding for the scottish component of a research project can be sought

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Dr Moir wrote to Dr Forrester expressing reservations against providing funding for a research project involving one Scottish Transfusion Centre

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Dr Gunson wrote that it was incorrect that "no Scottish Centre was now being asked to participate" in the multi-centre study and that he was "dismayed" to read SNBT would be applying for funding for surrogate testing from 1 April 1988, as he had understood that "Scotland would not take unilateral action" in introducing surrogate testing without consultation with regional transfusion directors in England and Wales

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Professor Cash wrote to Dr Gunson, suggesting he should not take the content of the minutes in relation to surrogate testing "too seriously at this stage" as "the results of the UK study are unlikely to have a material affect [sic] on future operational practice."

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De Kernoff and Dr Colvin stated in a paper for the Haemophilia Working Party that the acute NANBH, appeared generally mild, though might sometimes be fatal, but the chronic NANBH seemed "very possible that there may be serious long-term sequelae"

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In oral evidence given to the Inquiry, Dr Morris McClelland explained that he could not recall whether the SNBTS guidelines regarding surrogate testing were adhered to and he followed "National decision making" in reference to surrogate testing in Northern Ireland.

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Dr Scott in an internal minute written to Dr McIntyre believed "we should prevent the BTS from doing a full scale introduction" of surrogate testing.

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Dr Gunson completed a funding application for a multi-centre study into surrogate testing and ALT.

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A letter published in the The Lance by Dr Contreras and colleagues at the North London Blood Transfusion Centre commented that if "the true incidence of post-transfusion NANB hepatitis and its serious clinical sequelae are at a much lower level than reported from the USA, then screening of donations to reduce the incidence of NANB hepatitis may not be cost effective in the UK".

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