Thrombophilia (Hypercoagulation) Investigation - RGH/Pasqua - Saskatoon

Discipline

Hematology - Special Coagulation

Overview

Description

Ordering recommendations

RGH/Pasqua	Tests will include: Anti- B2, Anti-Cardiolipin antibodies, Antithrombin, Factor V Leiden Prothrombin G20210A, Lupus Anticoagulant, Protein C and Protein S Forms required: Investigation requisition: Hyper-Coag/Bleeding Disorder/Lupus Anticoagulant LAB Hema (RQHR 217) Also will accept original requisition completed by ordering physician
Saskatoon	Tests will include – Anti-Cardiolipin antibodies, Antithrombin, Factor V Leiden, Homocysteine, Lupus Anticoagulant, Protein C, Protein S and Prothrombin G20210A Form required: Thrombophilia Investigation requisition – form #101521 Patient should not be on anticoagulant therapy. If unable to discontinue anticoagulant therapy, suggest consultation with Hematopathologist prior to ordering.

Alias

Anti-Beta-2-glycoprotein, Anticardiolipin Antibody, Anti-Phospholipid Ab, Antiphospholipid Antibody, Antithrombin III, DRVVT, Factor V Leiden, Hypercoaguable workup, Lupus Anticoagulant, Protein C, Protein S, Prothrombin G20210A, PT Mutant

Specimen Information

Specimen types accepted

Whole Blood
Frozen aliquots if shipping from rural (Dry ice preferred. Must arrive frozen at -20°C)

Specimen collection container

3 x Blue (3.2% Buffered Sodium Citrate) and
2 x Red, non-gel and
1 x Lavender K2 EDTA
- Saskatoon Only: Additional Lavender K2 EDTA on ice

Collection procedure

Na citrate tube must be filled until the vacuum on the tube is completely exhausted
Red top serum tube filled
EDTA tube filled
Specimens shall be drawn by venipuncture
In the event that this is not possible, the specimen shall only be tested after being approved and reviewed by the Hematopathologist on call
Saskatoon only:
- See Collecting and Shipping Specimens for Coagulation from Laboratories outside Saskatoon

Required volume

Optimal volume

Two 2.7mL Blue (Socium Citrate) and
4 mL Lavender (EDTA) (for F5Leiden and Prothrombin 20210A) and
5.0 mL Red, non-gel (for Anti-Cardiolipin)
Saskatoon only
- Additional 4 mL Lavender (EDTA) (for Homocysteine) placed on ice and immediately transported to laboratory

Minimum volume

Two 1.8 mL Blue (Sodium Citrate) and
3 mL Lavender (EDTA) (for F5Leiden and Prothrombin 20210A) and
3 mL Red, non-gel (For Anti-Cardiolipin)
Saskatoon only
- Additional 1mL Lavender (EDTA) (for Hemocysteine) placed on ice and immediately transported to laboratory

(Submitting the minimum volume makes it impossible to repeat the test or perform confirmatory/reflex testing. In some situations, a minimum volume may require a second collection.)

Transport and stability

RGH/Pasqua	Whole blood specimens shall be received at RGH Special Coagulation within 2 hours of collection. Frozen aliquots stored at -20° C must be received at RGH Special Coagulation within 2 weeks. Whole blood EDTA received at room temp. 7 day stability. Ship to RGH ASAP.
Saskatoon	Whole blood specimen shall be received at RUH Coagulation Laboratory within 2 hours of collection

Rejection criteria

Line draws
Hemolysis
Clotted
Inappropriately filled tubes
Frozen aliquot specimen shipped without dry ice
Plasma specimen that has thawed for more than 2 hours
Plasma specimen that has thawed and been refrozen
Pathology and Laboratory Medicine Acceptance and Rejection Criteria
Saskatoon only
- Patient on anticoagulant therapy testing must be approved by the Hematopathologist on service

Testing Information

Relevant clinical history

Clinical details relevant to test results
Medication history particularly anticoagulant history

Performance

Days/times performed

RGH/Pasqua	RGH Special Coagulation Laboratory Monday-Friday 07:30-16:00 Outside of these hours contact switchboard for Hematopathologist on call to arrange testing.
Saskatoon	RUH Special Coagulation Laboratory Monday to Friday 07:30 – 16:00 excluding statutory holidays unless cleared by the Hematopathologist on call

Maximum laboratory time

RGH/Pasqua	Specimens are batched
Saskatoon	Specimens are batched and performed once per week

Specimen retention time

Specimen is discarded after reporting.
If an extra specimen is collected it is retained at -70°C

Last Updated: November 26, 2024