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Throughout the 1970s liver function tests performed on patients at Belfast Haemophilia Centre showed persistent abnormal liver function.

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According to Dr Mayne, there was increasing evidence that NANB hepatitis was not as benign as had been thought but could progress from chronic persistent hepatitis to cirrhosis.

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Dr Mayne enquired with Dr Craske as to the relevance to haemophilia "he reminded us that the individuals cited in the paper were known to maintain their lifestyle by being paid blood donors, as was documented in the World in Action (1975) programme."

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Dr Mayne noted manifest advantages of Factor VIII concentrates over cryoprecipitate, such as accurate calculated dosage to be given in small volume, associated with a decreased chance of clinical side effects.

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Dr Mayne stated that the possible significance of asymptomatic hepatitis became apparent by 1978, when structural abnormalities of the liver were described in patients.

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Patient discharge summary from Dr Mayne to Dr Wallace suggested the first use of Factor VIII concentrate in Belfast Haemophilia Centre.

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Dr Mayne instituted a home treatment programme using commercial concentrate, whereby all home treatment patients were treated with Kryobulin, all hospital treatment was with Hemofil while children continued to be treated with cryoprecipitate.

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David Williams of Speywood noted that Dr Mayne was not prepared to change her policy concerning human factor VIII.

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Dr Mayne wrote to David Williams, explaining that in view of likely expansion of home treatment programme and increased needs for commercial Factor VIII, further order for Koate might be placed with Speywood.

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The 1977 annual return recorded that Belfast Haemophilia Centre used no NHS Factor VIII concentrate.

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The 1976 annual return recorded for the Belfast Haemophilia Centre the use of cryoprecipitate and commercial concentrates (Hemofil and Kryobulin). Some NHS concentrates were used.

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The Belfast Haemophilia annual returns for 1978 showed the use of cryoprecipitate (250,646), NHS concentrate (186,992), Hemofil (290,599) and Kryobulin (334,390).

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In 1979 the vast bulk of treatment at the Belfast Haemophilia Centre was with commercial concentrates (Hemofil: 557,655 units, Kryobulin: 440,051).

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In her statement to the Inquiry, Dr Mayne noted that she performed liver function tests on patients at Belfast Haemophilia Centre as she was apprehensive about the long term effects of IV treatment.

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In a HIV Haemophilia litigation report, Dr Mayne suggested that the risk of NANB could progress to Hepatitis was known in 1977 but the full significance of its effects was not investigated until the mid-late 1980's.

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Eric Preston in his statement to the Lindsay Tribunal noted that the haemophilia centre at Sheffield was first based at the Royal Infirmary before moving to Royal Hallamshire Hospital. It was a reference centre but not one of the larger reference centres.

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The first director of the Haemophilia Centre at Sheffield was Professor Eddie Blackburn.

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In his statement to the Lindsay Tribunal, Dr Preston believed that in 1978 it had been shown that Non A-Non B Hepatitis was a very serious disorder.

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In his statement to the Lindsay Tribunal, Dr Preston asserted that the amount of Factor VIII and Factor IX given in the Haemophilia Centre was much less than that in other centres.

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Sheffield Haemophilia Centre participated in a formal trial of an Armour heat-treated concentrate beginning in April 1984. Two patients became ill with hepatitis. Dr Preston's recollection was that they withdrew from that study and moved to a study with colleagues in other centres, using an Alpha product.

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