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The Sheffield haemophilia centre was a reference centre, but not one of the larger centres. At Sheffield, there was a particular focus on hepatitis and liver disease, with significant research being undertaken there.

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At the Sheffield haemophilia centre, the amount of Factor 8 and Factor 9 given to patients was very much less than other reference centres, although Dr Preston did not think this reflected a deliberate decision to take a conservative approach.

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Dr Preston told the Observer "in 1978 we showed quite definitely that non-A, non-B was a very serious disorder. The Department of Health should have responded by pushing for ways to inactivate the virus in the blood, or given patients the choice of an alternative."

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Dr Preston confirmed his views to the Inquiry that "The Department of Health should have responded by pushing for ways to inactivate the virus in the blood, or given patients the choice of an alternative."

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A survey between Sheffield and the Royal Free showed that approximately one third of the patients studied had the appearance of chronic active (aggressive) hepatitis.

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Dr Preston's policy was to treat people with mild haemophilia with DDAVP as soon as it became available.

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Dr Preston stated in his evidence to the Inquiry that whilst the hepatitis risk from commercial products was substantially greater than from NHS products, "there were insufficient NHS products for the treatment of Royal Hallamshire Hospital patients".

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Dr Preston confirmed that part of his approach to patients was to "keep individual patients on the same concentrate, and the same 'batch' for as long as possible to minimise exposure to different blood donations"

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Dr Preston does not recall telling patients that the treatment they were receiving might expose them to the risk of chronic liver disease.

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Dr preston's view was that the amount of Factor 8 (and Factor 9) given to patients was very much less than the majority of other reference centres.

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Dr Preston's approach to purchasing a number of different commercial concentrates was "not putting all the eggs in one basket in case something happened with the supply chain..." and "keep individual patients on the same concentrate, and the same 'batch' for as long as possible to minimise exposure to different blood donations."

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It was the view of the reference centre directors at the special meeting on 13 May 1983 that cryoprecipitate was not particularly easy to use as there was no guarantee of the amount of Factor 8 in each bag, and it was not a particularly useful therapeutic option for major surgery or major bleeds.

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Inquiry publishes timetable for further evidence from panels and expert groups

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The results of a survey between Sheffield and the Royal Free on chronic hepatitis showed that approximately one third of the patients studied had the appearance of chronic active (aggressive) hepatitis.

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A letter to The Lancet in 1982 reported that "we have previously shown that there is a high incidence of chronic liver disease among patients receiving blood product concentrates even in the absence of any symptoms."

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The annual return for 1976 showed the Sheffield Haemophilia Centre treating its patients with cryoprecipitate, NHS Factor 8 and commercial concentrates.

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It was noted in the Annual Returns for Sheffield Haemophilia Centre for 1977 'that "home treatment packs' from ARMOUR have been used most of the time for home therapy."

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In 1979 the Sheffield Haemophilia Centre's return recorded no cryoprecipitate use at all for people with Haemophilia A.

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Annual returns for Sheffield Haemophilia Centre in 1980 recorded that a small amount of cryoprecipitate was used, but the mainstay of treatment was commercial concentrate

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In 1980, in the Sheffield Haemophilia Centre, a small amount of cryoprecipitate was used, but the majority of treatment was commercial concentrate (4,690 units of cryoprecipitate; 141,775 units of NHS concentrate; 800,852 units of commercial concentrates (Factorate, Hemofil, Kryobulin)).

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