Haemostatic Profiling Reveals Clinically Significant Coagulation Abnormalities Missed By Standard Donor Screening: A Case for expanded pre-donation assessment in resource- limited Settings

ABSTRACTRoutine pre-donation screening in resource-limited settings evaluates infectious disease markers, haemoglobin, and basic vital signs, leaving the haemostatic competence of donated blood systematically unassessed; this study therefore evaluated haemostatic biomarker abnormalities among serologically cleared voluntary blood donors at a Nigerian tertiary referral centre. A cross-sectional analytical study of 180 voluntary blood donors at University College Hospital (UCH), Ibadan, measured six biomarkers; platelet count (Sysmex XN-1000), fibrinogen (ELISA), prothrombin time (PT), international normalised ratio (INR), activated partial thromboplastin time (aPTT), and D-dimer (ELISA), with data analysed using IBM SPSS version 26. Most donors (83.3% male; 26–35 years predominant) had normal biomarker profiles; however, shortened PT indicating a hypercoagulable phenotype was detected in 35.0% (n = 63), prolonged aPTT in 11.7% (n = 21), platelet count abnormalities in 20.6% (thrombocytopenia 10.1%; thrombocytosis 10.5%), elevated fibrinogen in 4.4%, and elevated D-dimer in 2.8%, with all participants having cleared standard infectious disease screening. Overall, a substantial proportion of serologically cleared donors harboured haemostatic abnormalities, most notably a hypercoagulable phenotype in more than one in three donors, providing an evidence-based argument for incorporating haemostatic profiling into pre-donation assessment frameworks in resource-limited settings.