Tribunal will hear Ireland pioneered safe clotting agents

The Republic was the first country in the world to offer all of its haemophiliacs safe synthetically-produced blood clotting …

The Republic was the first country in the world to offer all of its haemophiliacs safe synthetically-produced blood clotting agents, it will emerge at the Lindsay tribunal, which resumes today.

The products were first sanctioned in 1995 when Prof Ian Temperley, who has been criticised by several tribunal witnesses, was director of the National Haemophilia Treatment Centre.

The medical director of the renamed National Centre for Hereditary Coagulation Disorders, Dr Owen Smith, who was appointed in late 1995, said yesterday that Prof Temperley had campaigned for years to get the synthetically produced recombinant factor concentrates for his patients. They are extremely expensive.

In mid-1995 the Department of Health agreed to pay for the treatment for under-12s, and in late 1997 the then minister for health, Mr Brian Cowen, decided that all patients should get recombinant factor VIII clotting agents.

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"By the end of the year, Ireland became the first country in the world to offer all of its haemophiliacs recombinant factor VIII replacement therapy," Dr Smith said. When recombinant factor IX became available later, it was also given to all patients.

"Recombinant products would be deemed by us to be state-of-the-art treatment. Nobody that I know has become infected from recombinant factor VIII or IX," Dr Smith said.

Haemophiliacs - always male - suffer from a blood-clotting disorder and need one of a number of agents, usually factor VIII, to prevent them bleeding to death.

Before the development of synthetically produced agents, clotting factors were derived from pooling thousands of human blood-donor plasmas together and purifying the desired factor concentrate.

Before methods to deactivate viruses carried in plasma were found, factor concentrates transmitted the HIV and hepatitis viruses. During the early 1980s at least 90 per cent of the severely affected patients who have haemophilia in Ireland were infected with HIV and/or hepatitis C.

The Lindsay tribunal is investigating how some 260 haemophiliacs in the State became infected with HIV and hepatitis C from contaminated blood products.

Dr Smith has also advocated the construction of a purpose-built treatment centre for haemophiliacs. A "one-stop shop" to care for haemophiliacs on the grounds of St James's Hospital, due to open in August, will go some way towards that.

Half the cost of the centre was raised by Dr Smith, who engaged architects to draw up plans for it before approaching the Department of Health to seek approval. His next battle will be to secure adequate staffing for the unit.

Haemophiliac children are at present treated at the National Children's Hospital in Tallaght, but Dr Smith, a consultant paediatric haematologist, says it would be logical to treat all haemophiliacs at the new centre at St James's. "That is what doctors, patients and haemophiliacs want and it should not be lost in inter-hospital politics," he said.