International Journal of Research and Reports in Hematology

Blood transfusion is a life-saving procedure essential for various medical conditions. The primary objective of blood transfusion is to ensure the safety, adequacy, accessibility, and efficiency of the blood supply at all levels. The safety of blood transfusions hinges on the careful screening of donors. However, the lack of timely access to well-screened, safe blood has led to many preventable deaths in Nigeria. This study aimed to assess and compare demographic characteristics, as well as certain hematological and immunological parameters (CD4 and CD41), to provide a foundation for revising Nigeria's blood transfusion policy.

The research was conducted at the Blood Bank Unit of the University College Hospital (UCH) in Ibadan, focusing on three categories of blood donors: commercial donors (CD), family replacement donors (FRD), and voluntary non-remunerated blood donors (VNBD), the latter being considered the safest and used as a control group in the study. A total of 360 apparently healthy donors were recruited. Hematological analyses were performed using a Sysmex 5-part hematology auto analyzer (CELL-DYN/EMERALD 22), CD4 counts were obtained via the BD FACSPresto™ CD4 Auto Analyzer, and CD41 levels were measured using a Human CD41 ELISA Kit. The data were analyzed using the Statistical Package for Social Sciences (SPSS) Version 25.0, with statistical significance set at P<0.05.

The comparison of hematological parameters among the three donor groups showed a decrease in the mean values of white blood cell (WBC) count, platelet count, and red blood cell (RBC) count in FRD compared to VD, though these differences were not statistically significant. However, significant decreases were observed in CD compared to VD in WBC count (p=0.012), platelet count (p=0.044), packed cell volume (PCV) (p=0.024), hemoglobin (HB) (p=0.009), mean corpuscular volume (MCV) (p=0.013), mean corpuscular hemoglobin (MCH) (p=0.042), and mean corpuscular hemoglobin concentration (MCHC) (p=0.004). CD4 levels were also lower in FRD and CD groups compared to VD, but without statistical significance. Similarly, CD41 levels were reduced in FRD and CD compared to VD, though these differences were not statistically significant either.

In conclusion, the study revealed compromised erythropoiesis in commercial donors due to repeated donations, as well as weakened immune status and potential poor platelet quality. Given the insufficient number of VNBDs to meet the country's needs and the clinical abnormalities detected in readily available commercial donors, encouraging family replacement donors who demonstrated similar hematological and immunological profiles to voluntary donors should be prioritized. Additionally, implementing stricter screening protocols that assess comprehensive hematological parameters and immunological markers, such as CD4, would improve donor safety and enhance the quality of blood products for recipients.