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The approval given by the Treasury in November 1982 for the reconstructed BPL was for a plant capable of fractionating 400,000 kilograms per annum.

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If the PFC processed plasma to produce Factor 8 for England, then less would be needed to be spent on BPL, since BPL would then process smaller quantities of plasma, and since smaller quantities required less manufacturing space and equipment, it would cost less to build.

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Peter Wormald, Under-Secretary in the DHSS, understood that the reasons for the policy of self-sufficiency was "that imported products were very expensive and in general were considered to carry much higher risk of cross-infections, particularly hepatitis".

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Peter Wormald noted that "although no decision had been yet on the redevelopment of BPL, there was a need to determine its future capacity; which in turn raised the issue of what part Liberton would play in meeting capacity."

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Peter Wormald noted "There appear to have been some follow-up discussions, but I was not copied into the papers and I do not know what action, if any, resulted. It is possible that the discussions took a back seat in September when the Medicines Inspectors' report on BPL was presented."

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In November 1979 Dr Lane proposed a scheme that allowed regions to receive their concentrate and albumin in proportion to the yield from the plasma they had sent to BPL. He argued that that would provide regions with a meaningful link to BPL and would incentivise and improve the plasma collection system.

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After adjustments to the pro rata principle, to deal with special cases such as Treloar's, the DHSS introduced the distribution of blood products scheme with effect from 1 April 1981.

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Efforts were made by Dr Maycock and his colleagues to persuade clinicians to use less whole blood and more packs of concentrated red blood cells. In Scotland the service had by 1974 managed to use some 30-40% of donations in this way, England achieved less than 10%.

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The reluctance of regional health authorities to fund a greater supply of plasma to the central production facilities was to be paid by the DHSS centrally.

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It became apparent that the system of using five-litre packs of plasma was not compatible with good manufacturing practice, unless the "pooling" of the plasma donations before filling the packs took place in aseptic units.

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Trials using single plasma packs began in late 1980.

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The combined effects of a pro rata scheme and the widespread use of single plasma packs were probably responsible for an increase in the amount of fresh frozen plasma received at BPL in 1981/82.

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Generally only 180ml of plasma could be removed from each donation.

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It was recommended that SAG-M be introduced as soon as possible, and it was to be expected that it would yield a considerable increase in plasma which might be available to BPL for fractionation.

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Dr Lane recorded that it was in the last quarter of 1984 that plasma supplies to BPL increased as a result of SAG-M.

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Plasmapheresis first began in the United Kingdom in early 1967.

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The Joint Steering Committee on Blood Products Production thought that the use of plasmapheresis might be difficult to justify as a means to meet targets because it inevitably exposed donors to risk.

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The Central Committee for the National Blood Transfusion Service expressed the view that increased plasma supplies could be achieved either by increasing concentrated red cell use or by plasmapheresis.

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In a meeting between Dr Biggs and Dr Rizza, they explored the Factor 8 market and investigated the reasons for choosing one commercial brand over another.

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A DHSS minute recorded that it was not the intention to embark on a programme of plasmapheresis in England.

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