THE first clotting products derived from blood plasma were produced in 1966.
Haemophiliacs were given these products, known as Factor VIII and Factor IX concentrates, which were made by distilling and concentrating the plasma of large groups of donors, sometimes as many as 25,000.
But for thousands of haemophiliacs, what seemed like a miracle cure was to lead to prolonged illness and, in many cases, death.
Factor VIII, IX and cryoprecipitate were manufactured by the Protein Fractionation Centre of the SNBTS (Scottish National Blood Transfusion Service). Scotland has been largely self-sufficient in blood products and indeed exported millions of units to the NHS in England. There was considerable confidence in the local supply, but it was to be misplaced.
In 1981, 60 people with haemophilia were infected with HIV in Scotland, 23 of them at the Royal Infirmary in Edinburgh, the ERI, from two, or three, donations. Almost all of them are now dead.
But it wasn’t just HIV which was passed on, but Hepatitis C, originally known as Non-A and Non-B (NANB), was also there.
In 1972 the UK NHS began importing some commercial blood products from the US, largely collected from prisoners.
In 1975, Dr Joseph Garrott Allen, an expert on blood at Stanford University in California, wrote to Dr William Maycock, head of the UK transfusion service, to warn him of the dangers of using US plasma from highrisk, paid “skid row” donors, including from penitentiaries.
In June 1982, the Medicines Inspectorate questioned the collection of blood from prisons and detention centres in Scotland, which had been going on for more than 25 years.
The matter was discussed at a SNBTS directors’ meeting in March 1983, where it was decided it was “not possible to agree a future policy”. Scotland had been collecting blood since 1957, in mobile transfusion units from prisoners all over the country to top up supply. Prisoners were induced to participate on the promise of cigarettes and sweets, although the official explanation was that they were anxious to show rehabilitation by contributing to society.
It was to change in July 1984 when two Glasgow doctors, Edward Follett from Ruchill and Brian Dow of the SNBTS, published a report on their three-year study of Non-A and Non-B hepatitis (Hep C) in transfusions in the West of Scotland. Of the 10,655 donations they tested approximately one half (5,057) were from prisoners. Some of these were intravenous drug users. The prisoners’ blood showed 10 times the level of alanine aminotransferase (ALT) – a marker of liver damage – than the other donors.
It was this report which, finally, persuaded SNBTS to stop prison collections. But because there were no adequate records about who had been given transfusions it was impossible to trace recipients of the blood.
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