Specimen Collection Manual and Test Catalog

2 mL aliquot of frozen platelet-poor plasma; minimum 0.5 mL. Please submit a separate frozen aliquot for this test. It may not be combined with any other test requiring a frozen aliquot.

3.2% citrate plasma, shipped frozen, is the only acceptable sample type. All other anticoagulants (heparin, EDTA, oxalate) are NOT acceptable. Proper blood to anticoagulant ratio is required: Vacutainer(R) tubes must be filled to completion to ensure the proper 9:1 blood to anticoagulant ratio is achieved. Routine collection requires 4.5 mL blood added to 0.5 mL sodium citrate. For patients with normal hematocrits, no adjustment is necessary. If the patient has a known hematocrit above 55%, adjust the amount of anticoagulant in the collection tube before drawing the blood according to the NCCLS guidelines below.

NCCLS Guidelines: Anticoagulant vol. [x]=(100-hematocrit)/(595-hematocrit)x total vol. of anticoagulated blood required. Example: Patient hematocrit = 60% (100-60)/(595-60)x 5.0 = 0.37 mL sodium citrate for a 5 mL standard drawing tube. 

To avoid contaminating the sample with tissue thromboplastin or heparin, follow the guidelines below. These substances may alter results: The venipuncture must be clean, with no trauma. Hemolyzed samples are not acceptable. The first 5 mL of blood drawn from a patient should not be used for coagulation testing. If drawn through an indwelling catheter, flush with 5 mL of saline and discard the first 5 mL of blood collected before collecting the specimen for coagulation testing. Blood should not be collected from heparinized lines.

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 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 ship on dry ice.

Frozen.

Room temperature: Unacceptable. Refrigerated: Unacceptable. Frozen: 1 month (-70°C).

Specimens transported at room temperature or refrgierated. Stability limits exceeded. Gross hemolysis • Grossly lipemic • Grossly icteric.

Plasminogen activity.

Quest test code 4458, PLACT

Decreased plasminogen activity may be inherited or acquired. Acquired deficiencies may occur with: tranexamic acid and L-asparginase use, disseminated intravascular coagulation (DIC), liver disease, during and after thrombolytic therapy, sepsis, and hyperthyroidism. Plasminogen activity is developmentally regulated reaching adult levels at approximately 6 months of age. As a positive acute phase reactant, increased levels are associated with infection, trauma, surgery, inflammation and malignancy.