Evaluation of Coagulation Disorders among Blood Donors at the University College Hospital, Ibadan, Nigeria

Abstract

Background: Donor safety and the quality of transfusion products may be impacted by coagulation disorders, which can range from hypocoagulable to hypercoagulable states and stay clinically silent in seemingly healthy persons. Sensitive coagulation testing is rarely included in routine donor screening, which often focuses on transfusion-transmissible pathogens. In order to ascertain the prevalence and interrelationships of anomalies and to take into account consequences for donor screening and transfusion safety, this study evaluated a few coagulation markers among blood donors at the University College Hospital (UCH) blood bank in Ibadan. Aim and Objectives: The purpose of the study was to assess coagulation abnormalities in a subset of UCH Ibadan blood donors. Prothrombin Time (PT), International Normalized Ratio (INR), Activated Partial Thromboplastin Time (aPTT), fibrinogen concentration, and D-Dimer levels were measured, and correlations between these indicators were investigated. Materials and Methods: A cross-sectional investigation was carried out on 200 willing blood donors who were enlisted at the UCH blood bank. Donors between the ages of 18 and 60 who completed the standard pre-donation test were accepted; those who were not in the age range, were using antithrombotic medications, or failed the screening were not. Venous blood was drawn into 3.2% sodium citrate tubes; fibrinogen and D-Dimer were tested by ELISA, plasma was produced, and PT/aPTT was assessed by hand. Significance was determined at p<0.05 and data were analyzed using SPSS (descriptive statistics, Pearson correlations). The determination of sample size and laboratory procedures adhered to accepted practices. Results: With mean PT 15.2 s, mean INR 1.16, mean aPTT 34.7 s, mean fibrinogen 1.73 g/L, and mean D-Dimer 0.007, the majority of donors had coagulation parameters within reference limits. But 46/200 (23.0%) showed at least one coagulation abnormality: 13/200 (6.5%) had high INR (>1.2), 8/200 (4.0%) extended aPTT (>40 s), 7/200 (3.5%) low fibrinogen (<1.5 g/L), 5/200 (2.5%) high fibrinogen (>4.0 g/L), and 23/200 (11.5%) positive D-Dimer (≥0.05). Correlational analysis revealed a small but statistically significant negative correlation between fibrinogen and D-Dimer (rho = −0.208, p = 0.003) and the expected substantial PT–INR connection (r=0.966, p<0.001). Conclusion: D-Dimer increase (11.5%) indicates a subset with subclinical fibrin production and breakdown. Approximately one in four blood donors exhibited at least one laboratory marker of coagulation abnormalities. These results encourage blood banks to take into account tiered or targeted coagulation screening in order to safeguard donor health and transfusion quality. Adopting point-of-care PT/INR and aPTT screening for donors, deferral or referral paths for bad results, and improved donor questionnaires are among the recommendations.