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In December 1975, the West Midlands Regional Health Authority recorded difficulties in producing sufficient plasma and it was agreed that commercial Factor 8 (Kryobulin) would need to be purchased at an annual cost to the region of £350,000.

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Demand for cryoprecipitate was going down and NHS concentrates were not being used at the rate that had been predicted

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In 1976 the Queen Elizabeth Hospital had used 500,000 units of commercial Factor 8 for home treatment, because all the NHS product having been used for treatment in hospital and for dental cases.

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During 1977 the Queen Elizabeth Hospital used significant amounts of commercial Factor 8 (almost double the amount from the previous year) as well as NHS Factor 8 (at a similar level to the previous year)

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At a Working Party meeting Dr Stuart stated that during 1976 Queen Elizabeth Hospital had used 500,000 units of commercial Factor 8 for home treatment, with all the NHS product having been used for treatment in hospital and for dental cases. He stated that his preference was to have all his Factor 8 from the same source, and that he was minded to discontinue cryoprecipitate as a home treatment and use NHS product instead.

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During 1977 Queen Elizabeth Hospital used significant amounts of commercial Factor 8 as well as NHS Factor 8

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Dr Stuart of Queen Elizabeth Hospital stated that only a third of Queen Elizabeth Hospital's Factor 8 product was received from the Lister, meaning the two-thirds shortfall had to be made up with commercial concentrates.

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During 1978 little cryoprecipitate was used and the NHS and commercial factor VIII levels broadly remained similar to the year before at the Birmingham Haemophilia Centre

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In 1979 almost no cryoprecipitate was used and the amount of commercial concentrate was well over double the amount of NHS concentrate at the Birmingham Haemophlia Centre

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Professor Frank Hill at the time believed hepatitis was a minor self limiting condition with no serious long-term consequences

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Dr Hill and Dr Stuart were concerned about the risks of hepatitis and were of the view that it would have been advantageous to reserve NHS Factor 8 for children.

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By 1975 Dr Colvin was aware that there was at least a possibility of chronic liver disease in haemophilia

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Dr Hill reported to the December 1979 meeting of the West Midlands Working Party that the Hepatitis Working Party had reported that Commercial Factor VIII carried the risk of hepatitis, and he was concerned that some children at the Childrens Hospital had become hepatitis carriers

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In 1979, Dr Kernoff held that while cryoprecipitate was cheap to produce it had serious clinical disadvantages and that the NHS's shortfall had to be addressed through buying commercial concentrate.

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In 1979, Dr Kernoff described NANBH was a serious disease with long-term consequences.

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In 1979 Dr Kernoff and Dr Colvin authorised guidelines for the screening and investigation of liver functioning and Hepatitis B tests, implementing closer monitoring of patients.

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In December 1979, the Haemophilia Working Party met and discussed the fact that up to 70% of patients with severe haemophilia had abnormal liver function tests, with a wide spectrum of histological abnormalities.

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In 1970, at the haemophilia centre at Leeds, based at St James's University Hospital Dr Layinka Swinburne was the director and in 1985, she was joined by Dr Bernard McVerry.

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By 1977 the haemophilia centre at Leeds, based at St James's University Hospital were using a substantial amount of commercial concentrates.

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The haemophilia centre at Leeds, based at St James's University Hospital showed no evidence of batch dedication or evidence of risk reduction.

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