Ordering Guidance

Coagulation testing is highly complex, often requiring the performance of multiple assays and correlation with clinical information. For that reason, consider ordering Coagulation Consultation.

Necessary Information

Specimen Required

Specimen Type: Platelet-poor plasma

Patient Preparation:

1. Specimen must be collected prior to initiation of anticoagulants and thrombolytic therapy.

2. Patient must not be receiving warfarin, heparin, direct thrombin inhibitors (argatroban, dabigatran), or direct factor Xa inhibitors (apixaban, rivaroxaban, and edoxaban).

 a. If medically feasible, for 4 to 6 hours before specimen collection, do not administer intravenous heparin.

 b. If medically feasible, for 10 to 14 days before specimen collection, do not administer subcutaneous heparin or warfarin.

3. It is best to collect the specimen pretransfusion if possible. If patient has been recently transfused, wait at least 48 hours after transfusion to collect the specimen.

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Light-blue top (3.2% sodium citrate)

Submission Container/Tube: 13-mm x 75-mm, 5-mL, plastic vial (polypropylene preferred)

Specimen Volume: 1 mL Platelet-poor plasma

Collection Instructions:

1. Specimen must be collected prior to factor replacement therapy

2. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing.

3. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.

4. Aliquot plasma into a separate plastic vial, leaving 0.25 mL in the bottom of the centrifuged vial.

5. Immediately freeze plasma (no longer than 4 hours after collection) at -20° C or, ideally, -40° C or below.

Additional Information:

1. Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.

2. Each coagulation assay requested should have its own vial.