Antithrombin Activity

Single-analyte tests

• Antithrombin III Activity 216

  Plasma · Fasting not stated · Turnaround Set up: Tues-Sun (a.m.); Report available: 4 days

  Method and collection

  Method

  Chromogenic Substrate

  Collection

  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.

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• Antithrombin III Activity with Reflex to Antithrombin III Antigen 8267

  Plasma · Fasting not stated · Turnaround Set up: Tues-Sat

  Method and collection

  Method

  Chromogenic Substrate

  Collection

  Please submit a separate, frozen vial for each special coagulation assay ordered. Draw blood in a light blue-top tube containing 3.2% sodium citrate, mix gently by inverting 3-4 times. Centrifuge 15 minutes at 1500 g within one hour of collections. 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(s). Freeze immediately and transport on dry ice.

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Panels that include this biomarker

• Antithrombin III Activity and Antigen 7017

  2 analytes · Plasma · Fasting not stated

  Method and collection

  Method

  Chromogenic Substrate • Immunoturbidimetric

  Collection

  Please submit a separate, frozen vial for each special coagulation assay ordered. Draw blood in a light blue-top tube containing 3.2% sodium citrate, mix gently by inverting 3-4 times. Centrifuge 15 minutes at 1500 g within one hour 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(s). Freeze immediately and transport on dry ice.

  Reference notes

  ⁠⁠⁠⁠⁠⁠⁠Antithrombin III Activity 1 day-1 month | 41-108 % normal 31 days-2 months | 50-120 % normal 3-5 months | 73-120 % normal ≥6 months | 80-135 % normal Antithrombin III Antigen | 80-120 % normal

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• Thrombophilia Screen II, Inherited 11327

  4 analytes · Plasma · Fasting not stated

  Method and collection

  Method

  Polymerase Chain Reaction & Detection • Chromogenic Substrate • Clotting Assay • Immunoturbidimetric Reflex: Fluorescent Microspheres • Oligonucleotide Ligation Assay • Polymerase Chain Reaction (PCR)

  Collection

  This panel requires platelet-poor plasma and whole blood. Please submit a separate, frozen vial for each special coagulation assay ordered. Draw blood in a light blue-top tube containing 3.2% sodium citrate, mix gently by inverting 3-4 times. Centrifuge 15 minutes at 1500 g within one hour 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(s). Freeze immediately and transport on dry ice. Whole blood: Preferred shipping temperature is frozen, but room temperature shipping is acceptable.

  Reference notes

  See Laboratory Report

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• Thrombosis Panel 11051

  4 analytes · Plasma · Fasting not stated

  Method and collection

  Method

  Clotting Assay • Clot Detection • Chromogenic Substrate • RVVT-based Assay (Clot-based)

  Collection

  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/uL) Freeze immediately and ship on dry ice.

  Reference notes

  See individual tests

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• Venous Thrombosis Hypercoagulability Panel with Reflex (Warfarin Patient) 11472

  8 analytes · Plasma · Fasting not stated

  Method and collection

  Method

  Chromogenic • Immunoassay (IA) • Polymerase Chain Reaction and Detection • Clot Detection • dRVVT-based Clot Assay

  Collection

  Whole blood sample is for the Factor V Mutation Analysis and Prothrombin (Factor II) Mutation Analysis. Platelet-poor plasma is for remaining tests. Platelet-poor plasma: Centrifuge light blue-top tube 15 minutes at approximately 1500 x 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 six plastic vials. Plasma must be free of platelets (<10,000/mcL). Freeze immediately and ship on dry ice. Note: Storage of whole blood at refrigerated temperatures prior to processing may lead to cryoprecipitate formation and falsely low Factor VIII and von Willebrand Factor studies.

  Reference notes

  See Laboratory Report

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• Venous Thrombosis Hypercoag Panel w/Reflex, Consultation (Warfarin Patient) 19655

  10 analytes · Serum · Fasting not stated

  Method and collection

  Method

  See individual tests

  Collection

  Whole blood sample is for the Factor V Mutation Analysis and Prothrombin (Factor II) Mutation Analysis. Serum sample is for the Homocysteine. Red-top tubes: Place the specimen in a refrigerator or ice bath for 30 minutes after collection. Centrifuge the specimen as soon as possible after complete clot formation has taken place. Transfer the serum to a plastic screw-capped vial. Barrier gel separator tubes: Place the specimen in a refrigerator for 30 minutes after collection. Centrifuge the specimen as soon as possible after complete clot formation has taken place. Do not place barrier tubes in an ice bath as freezing may prevent the barrier gel from adequately separating serum from cells. Platelet-poor plasma is for the remaining tests. Platelet-poor plasma: Please submit a separate, frozen vial for each special coagulation assay ordered. Draw blood in a light blue-top tube containing 3.2% sodium citrate, mix gently by inverting 3-4 times. Centrifuge 15 minutes at 1500 g within one hour 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(s). Freeze immediately and transport on dry ice. Note: Storage of whole blood at refrigerated temperatures prior to processing may lead to cryoprecipitate formation and falsely low Factor VIII and von Willebrand Factor studies.

  Reference notes

  See Laboratory Report

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Single-analyte tests

• Antithrombin (AT) Activity 015040

  Plasma · Fasting not stated · Turnaround 2 - 3 days

  Method and collection

  Method

  The patient plasma is mixed with heparin and thrombin. The extent of thrombin inhibition is proportional to the AT concentration of the patient sample. Residual thrombin activity is measured as the rate of conversion of a chromogenic substrate and is used to calculate AT concentration.

  Preparation

  Do not draw from an arm with a heparin lock or heparinized catheter. Patients ideally should not be on unfractionated heparin or direct Xa inhibitor anticoagulant therapy.

  Collection

  Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood-to-anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples unless the sample is collected using a winged (butterfly) collection system. With a winged blood collection set a discard tube should be drawn first to account for the dead space of the tubing and prevent under-filling of the evacuated tube.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternative anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

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Panels that include this biomarker

• Antithrombin (AT) Deficiency Profile 015594

  2 analytes · Plasma · Fasting not stated · Turnaround 2 - 3 days

  Method and collection

  Method

  AT antigen: Automated (LIATEST) enzyme immunoassay (EIA) AT activity: The patient plasma is mixed with heparin and thrombin. The extent of thrombin inhibition is proportional to the AT concentration of the patient sample. Residual thrombin activity is measured as the rate of conversion of a chromogenic substrate and is used to calculate AT concentration.

  Preparation

  Do not draw from an arm with a heparin lock or heparinized catheter. Ideally, patients should not be on unfractionated heparin or direct Xa inhibitor therapy.

  Collection

  Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples, except when using a winged blood collection device (ie, "butterfly"), in which case a discard tube should be used.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze immediately and maintain frozen until tested. Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

  Reference notes

  In newborns, AT levels are lower than in adults (39% to 89%). Levels gradually reach adult ranges by six months of age.6

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• Thrombotic Risk, Congenital 117140

  3 analytes · Plasma · Fasting not stated · Turnaround 3 - 7 days

  Method and collection

  Method

  See individual tests.

  Preparation

  Do not draw from an arm with a heparin lock or heparinized catheter.

  Collection

  Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anti-coagulant with the blood. A discard tube is not required prior to collection of coagulation samples except when using a winged blood collection device (i.e., "butterfly"), in which case a discard tube should be used.4,5 When non-citrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap and recentifuge for 10 minutes. Use a second plastic pipette to remove plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze immediately and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested. It is important to centrifuge blood samples for plasma collection immediately after collection to separate the plasma from the blood cells. If immediate centrifugation is not possible, collected blood specimens should be kept on ice and centrifuged within an hour. Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

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• Thrombotic Risk, Congenital (Extended) 117185

  6 analytes · Serum · Fasting not stated · Turnaround 3 - 7 days

  Method and collection

  Method

  See individual tests.

  Preparation

  Do not draw from an arm with a heparin lock or heparinized catheter.

  Collection

  Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anti-coagulant with the blood. A discard tube is not required prior to collection of coagulation samples except when using a winged blood collection device (i.e., "butterfly"), in which case a discard tube should be used.4,5 When non-citrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap and recentifuge for 10 minutes. Use a second plastic pipette to remove plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze immediately and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested. It is important to centrifuge blood samples for plasma collection immediately after collection to separate the plasma from the blood cells. If immediate centrifugation is not possible, collected blood specimens should be kept on ice and centrifuged within an hour. Other plasma : It is important to centrifuge blood samples for plasma collection immediately after collection to separate the plasma from the blood cells. If immediate centrifugation is not possible, collected blood specimens should be kept on ice and centrifuged within an hour. Serum: Sample should be centrifuged as soon as possible after collection to avoid false elevation of homocysteine and transported in a completely separated gel barrier-tube (SST) or transfer tube. Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

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• Disseminated Intravascular Coagulation (DIC) Profile, Comprehensive Plus 117853

  10 analytes · Plasma · Fasting not stated · Turnaround 2 - 3 days

  Method and collection

  Method

  See individual tests.

  Preparation

  None

  Collection

  Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples, except when using a winged blood collection device (ie, "butterfly"), in which case a discard tube should be used.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze immediately and maintain frozen until tested. Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

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• Thrombotic Risk Assessment 117155

  14 analytes · Serum · Fasting not stated · Turnaround 3 - 7 days

  Method and collection

  Method

  See individual tests.

  Preparation

  Do not draw from an arm with a heparin lock or heparinized catheter.

  Collection

  Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anti-coagulant with the blood. A discard tube is not required prior to collection of coagulation samples except when using a winged blood collection device (i.e., "butterfly"), in which case a discard tube should be used.4,5 When non-citrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap and recentifuge for 10 minutes. Use a second plastic pipette to remove plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze immediately and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested. It is important to centrifuge blood samples for plasma collection immediately after collection to separate the plasma from the blood cells. If immediate centrifugation is not possible, collected blood specimens should be kept on ice and centrifuged within an hour. Serum: If a red-top tube is used, transfer separate serum to a plastic transport tube. Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

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