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The estimate of £6-7 million put a stop to any further discussions with Scotland regarding plans for the redevelopment of BPL and was described by Dr Walford as "a sort of bitter blow".

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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 change to single plasma packs proved efficient in saving time and resources at regional transfusion centres.

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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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The Scottish National Blood Transfusion Service Annual Report recorded that there was an increase of 82% in the number of units obtained by plasmapheresis of fresh frozen plasma. It seemed that Edinburgh, in particular, was using more plasmapheresis.

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The Code of Practice for the Clinical Use of Blood Cell Separators determined that a cardiac arrest team had to be available when machine plasmapheresis was used due to the risk of cardiac arrest occurring.

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Dr Robinson set up a pilot unit for plasmapheresis in Yorkshire in 1980.

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