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Pools used to prepare antihemophilic factor were 14-22 litres in size. This amounted to the use of pools made from a maximum of 90-110 donations. There was said to be no "contra-indications to the prolonged or repeated use of the product."

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Dr Peter Wolf commented "The risk of contamination of blood with the virus of infective hepatitis limits a single fractionation batch to a donor pool of 50" but "Human A.H.F. concentrate, produced in this way at multiple centres throughout the country, could provide sufficient to treat all the known classical haemophiliacs in Great Britain."

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Dr Maycock and Leon Vallet proposed to "retain the present pool size (30L) because of the risk of transmitting serum hepatitis."

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A working party on human antihaemophilic globulin decided "it was considered inadvisable, when planning increased production, to increase the plasma pool volume much above this size (30-40 litres in volume), unless further observations indicated that the risk was smaller than the present series of cases suggested."

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Dr Maycock wrote that in the UK antihaemophilic globulin ("AHG") was made from donor pools of 60-100 donors, and described a "paucity of reports of hepatitis" associated with this.

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Dr Jean Grant recorded that "It has been found that a minute fraction of a millilitre of virus-laden blood was enough to cause hepatitis and it was for this reason that the production of large-pool plasma, made from the contributions of more than 300 donors, was abandoned in favour of limited pools derived from not more than ten donors."

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Dr Robert Cumming and colleagues commented "Because of the risk of transmitting serum hepatitis, small-pool operation is preferable, in preparing antihaemophilic fractions."

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Dr Rosemary Biggs wrote to the MRC in advance, to say that she "also thought that we should probably consider the question of serum hepatitis and, in view of the American activities, whether or not it would be reasonable to increase the pool size for fractionation."

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Due to the pressure for an increase in the pool sizes used to make AHF, there was a meeting of a working party on the use of the cryoprecipitate method.

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Dr Cumming explained that "after consultation with clinicians using this material, it was decided that Edinburgh should use a pool of 8 litres. The clinical opinion in Edinburgh was that a pool of this size was sensible for general use but that larger pools could be used for major surgery where large quantities were required for one patient."

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Factor 8 and Factor 9 were made at the Plasma Fractionation Laboratory in Oxford. The number of donations in the mean pool size for Factor 8 in 1969 was 160 donations; in 1970 it was 192 and the same in 1971. In terms of Factor 9, larger pools were used: in 1969, 439 donations were the average, in 1970 it was 384, and in 1971, 300.

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Dr Biggs stated "The use of freeze dried concentrate (in comparison to cryoprecipitate) did not cause a dangerous increase in episodes of jaundice".

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The pools used to manufacture Factor 8 concentrate in 1983 could be almost 40 times as large as the number of donations used to treat patients at Oxford in 1971.

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The number of donations rose to 6,000 donations from 1982 to 1985. This was eight times the number of donations used in 1975, and more than 30 times as much as Dr Biggs recorded for Oxford in relation to 1971.

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Dr Joseph Garrott Allen had written that the risk of serum hepatitis from transfusions derived from prison and skid row populations was at least ten times that from the use of volunteer donors.

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Dr Carol Kasper and Dr Shelly Kipnis considered the risks of taking blood products prepared from pooled plasma more directly, and wrote that for older children and adults who had had little exposure to blood products, especially those with mild haemophilia, single-donor products were preferable.

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Dr Biggs wrote about the risks of hepatitis from using pools of the sizes from which her products came noting that an exception to this rule concerns the mildly affected patients to whom very little treatment is given where those patients seemed to have a high incidence of hepatitis if large pool fractions were used.

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In March, the expert group on the treatment of haemophilia considering Hepatitis B repeated what Dr Biggs had said.

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Scotland began planning to produce high-purity Factor 8 concentrates, with a planned production capacity for the new Protein Fractionation Centre of one pool of 200 litres per week.

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An option to increase the preparation of Factor 8 concentrate was discussed.

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