Haemophilia A and the blood transfusion service: a Scottish study

The demand for blood products containing factor VIII for treating patients with haemophilia A in south-east Scotland was reviewed. From 1961 to 1975 the demand for fresh frozen plasma (FFP), cryoprecipitate (CP), and antihaemophilic factor (AHF) increased by seven and a half times, while total donations increased by only a third. Patients with severe haemophilia A treated at the regional haemophilia centre used about 85% of the factor VIII issued in 1971-4, most of which was used on demand. A patient with severe haemophilia A on unlimited ondemand home treatment would need about 500 units of factor VII/kg body weight/year, and a regional haemophilia centre, treating moderate and mild cases as well as severe ones, would use 15000 units/patient/year. Altogether about 50 million units of factor VIII will be needed each year in the UK. Although cryoprecipitate is much harder to store and administer than AHF, its yield from plasma may be far greater and its cost far smaller. Unless the blood transfusion services receive increased amounts of money and reappraise their functions and operation, it seems likely that they will have to rely increasingly on commercial (and costly) sources for the major plasma fractions.