When Irene M. Sawvel checks into Huntington Memorial Hospital later this month for knee surgery, she won't be taking unnecessary chances.
"With all the things you hear about AIDS and hepatitis that you can get from blood transfusions, I decided to use my own blood so that I would not have any problems with that," said Sawvel, a banker who lives in Los Angeles.
Sawvel is one of an increasing number of surgery patients in the San Gabriel Valley who is opting to supply her own blood for transfusions. To prepare for her knee replacement, Sawvel has been accumulating the blood for her operation through a special self-donation program at the Pasadena hospital.
Although statistics indicate that only 2% of the reported AIDS victims in the United States contracted the disease through blood transfusions, San Gabriel Valley hospitals report a marked increase in the number of patients requesting autologous (self-supplied) donations since the AIDS problem came to light in early 1983.
For example, since the City of Hope National Medical Center in Duarte began offering its autologous service six years ago, requests have quadrupled, from 30 in 1980 to a record 120 in the fiscal year ending this month, said Jeanne M. Karr, blood donor coordinator for the hospital. In 1983, the year AIDS became a household word, the hospital had 41 requests.
The blood donor center at Huntington Memorial handled only one or two autologous donors in 1983, said blood services coordinator Mark Kaniewski. But that number jumped to 20 a month by 1984, and to 30 a month this year.
Although fear of acquired immune deficiency syndrome appears to be the primary motivator, the dread of other diseases--particularly hepatitis--and the belief among physicians that autologous donations are safest, is prompting patients to donate their own blood.
The autologous procedure, which for a number of years has been promoted by orthopedic surgeons performing elective surgeries such as hip and knee replacements, is now routinely recommended by a growing number of doctors.
"Autologous is the safest transfusion possible," said pathologist J. N. Carberry, director of the blood bank at St. Vincent Medical Center in Los Angeles.
In addition to safety, the autologous procedure also helps to stimulate bone marrow production "so that when you undergo surgery, your recovery period will be shorter," Carberry said. "If I was to have elective surgery, I would use autologous blood."
While many patients cite AIDS as their main concern, physicians agree that the risk of contracting hepatitis through blood transfusions is also a major consideration.
"The chances of contracting tranfusion-related hepatitis . . . are much greater than getting AIDS," said Dr. Roy Moffatt, an associate pathologist at St. Luke Hospital of Pasadena.
One person who is particularly concerned about the hepatitis risk is Linda Becker, a Pasadena mother who is expecting her third child in December. Becker, whose father survived a bout of hepatitis during World War II, fears the sometimes fatal disease that afflicts victims with jaundice, nausea and high fever.
"It's not a pretty disease," she said.
Becker required a transfusion three years ago when she hemorrhaged while delivering her second child, so her doctors suggested an autologous program in case there are problems with this delivery.
"There is a psychological benefit in knowing that it's there if needed," Becker said.
It was not fear of disease but doctor's orders that sent 72-year-old Carl Schlatter to the autologous program at Huntington Memorial. In fact, Schlatter, facing knee-replacement surgery, had not been aware that transfusions would be required.
But his doctors prescribed the autologous program and he visited the center twice last month to donate two units, roughly the equivalent of two pints of blood.
"It's nothing to get excited about," he said as he joked with the nurses.
Can Stockpile Blood
Those who opt for the autologous program can schedule their operations so that they can stockpile their own blood over a period of time before the surgery, an option generally unavailable to emergency surgery patients.
Health experts say that donor requirements for autologous blood are less stringent than those for the general blood bank. For example, an autologous donor taking certain medications could still donate because he alone will receive the blood, said Elaine Kruse, blood bank supervisor at Pomona Valley Community Hospital.
But not all elective surgery patients can take advantage of the autologous program. Those who do not meet general height, weight, and blood count requirements or who have been weakened by illness are discouraged from donating.
Autologous blood is drawn in the same way as blood for a general donor bank, but the drawing center must set aside refrigerated storage room for the autologous blood and provide adequate staff to handle the additional paper work.