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Thrombosis Panel
Test Code11051
CPT Codes
85300, 85303, 85306, 85307
Includes
Protein C Activity
Protein S Activity
Antithrombin III Activity
Activated Protein C-Resistance
Protein S Activity
Antithrombin III Activity
Activated Protein C-Resistance
Preferred Specimen
5 mL frozen platelet-poor citrated plasma collected in a 3.2% sodium citrate (light-blue-top) tube
Minimum Volume
2.5 mL
Instructions
Platelet-poor plasma: Centrifuge light blue-top tube for 15 minutes at approximately 1500 g within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid the WBC/platelet buffy layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma into a new plastic vial. Plasma must be free of platelets (<10,000/mcL) Freeze immediately and ship on dry ice.
Transport Temperature
Frozen
Specimen Stability
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days
Refrigerated: Unacceptable
Frozen: 14 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
See individual assays
Methodology
Clotting Assay • Clot Detection • Chromogenic Substrate • RVVT-based Assay (Clot-based)
Setup Schedule
Set up and Report available: See individual assays
Limitations
Protein C, Activity: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: decrease; Heparin (UFH or LMWH): UFH-no effect, LMWH-may falsely increase at higher levels; Dabigatran or Argatroban (Thrombin Inhibitors): may falsely increase; Rivaroxaban or Apixaban (Factor Xa Inhibitors): may falsely increase.
Protein S, Activity: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: decrease; Heparin (UFH or LMWH): may falsely increase at values approximately greater than 1.0 IU/mL; Dabigatran or Argatroban (Thrombin Inhibitors): may falsely increase; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect.
Antithrombin III Activity: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: no effect; Heparin (UFH or LMWH): no effect to decrease (UFH may decrease levels physiologically but no assay interference); Dabigatran or Argatroban (Thrombin Inhibitors): may falsely increase; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect.
Activated Protein C Resistance: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: no effect; Heparin (UFH or LMWH): no effect; Dabigatran or Argatroban (Thrombin Inhibitors): unable to obtain assay endpoint; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect.
Protein S, Activity: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: decrease; Heparin (UFH or LMWH): may falsely increase at values approximately greater than 1.0 IU/mL; Dabigatran or Argatroban (Thrombin Inhibitors): may falsely increase; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect.
Antithrombin III Activity: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: no effect; Heparin (UFH or LMWH): no effect to decrease (UFH may decrease levels physiologically but no assay interference); Dabigatran or Argatroban (Thrombin Inhibitors): may falsely increase; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect.
Activated Protein C Resistance: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: no effect; Heparin (UFH or LMWH): no effect; Dabigatran or Argatroban (Thrombin Inhibitors): unable to obtain assay endpoint; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect.
Clinical Significance
This panel is useful to determine the etiology of various hypercoagulability states.
