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Test Code AVWPR von Willebrand Disease Profile, Plasma


Ordering Guidance


Multiple coagulation profile tests are available. See Coagulation Profile Comparison for testing that is performed with each profile.



Shipping Instructions


Send all 3 aliquots in the same shipping container.



Necessary Information


1. If priority specimen, mark request form, give reason, and request a call-back.

2. Note if patient is currently receiving anticoagulant treatment (eg, heparin, warfarin).



Specimen Required


Specimen Type: Platelet-poor plasma

Patient Preparation:

1. Patient should not be receiving anticoagulant treatment (eg, warfarin, heparin). If not possible for medical reasons, note on request.

 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.

2. Patient should not be receiving fibrinolytic agents (streptokinase, urokinase, tissue plasminogen activator [tPA]).

3. It is recommended that specimens be collected pretransfusion. If patient has been transfused, a specimen should not be collected for 48 hours.

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

Submission Container/Tube: Plastic vials

Specimen Volume: 3 mL Platelet-poor plasma in 3 plastic vials, each containing 1 mL

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 (1-2 mL per aliquot) into 3 separate plastic vials, leaving 0.25 mL in the bottom of centrifuged vial.

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


Specimen Type

Plasma Na Cit

Specimen Minimum Volume

Platelet-poor plasma: 2 Plastic vials, each containing 1 mL platelet-poor plasma

Specimen Stability Information

Specimen Type Temperature Time
Plasma Na Cit Frozen 14 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Reference Values

An interpretive report will be provided.

 

COAGULATION FACTOR VIII ACTIVITY

Adults: 55-200%

Normal, full-term infants or healthy premature infants typically have levels greater than or equal to 40%.*

 

*See Pediatric Hemostasis References in Coagulation Guidelines for Specimen Handling and Processing.

 

VON WILLIEBRAND FACTOR ANTIGEN

55-200%

Note: Individuals of blood group "O" may have lower plasma von Willebrand factor (VWF) antigen than those of other ABO blood groups, such that apparently normal individuals of blood group "O" may have plasma VWF antigen as low as 40% to 50%, whereas the lower limit of the reference range for individuals of other blood groups may be 60% to 70%.

Children: Neonates, infants, and children have normal or mildly increased plasma VWF antigen, with respect to the adult reference range.

 

VON WILLEBRAND FACTOR ACTIVITY

55-200%

Normal, full-term infants may have mildly increased levels which reach adult levels by 90 days postnatal. Healthy, premature infants (30-36 weeks gestation) may have increased levels that reach adult levels by 180 days.

 

Note: Individuals of blood group "O" may have lower plasma von Willebrand factor (VWF) activity than those of other ABO blood groups, such that apparently normal individuals of blood group "O" may have plasma VWF activity as low as 40% to 50%, whereas the lower limit of the reference range for individuals of other blood groups may be 60% to 70%.

 

COAGULATION FACTOR VIII INHIBITOR SCREEN

Negative

 

RISTOCETIN COFACTOR

Adults: 55-200%

Note: Individuals of blood group "O" may have lower plasma von Willebrand factor (VWF) ristocetin cofactor activity than those of other ABO blood groups, such that apparently normal individuals of blood group "O" may have plasma VWF ristocetin cofactor activity as low as 40% to 50% whereas the lower limit of the reference range for individuals of other blood groups may be 60% to 70%.

 

Normal, full-term infants or healthy premature infants usually have levels in the adult range.

 

FACTOR VIII BETHESDA UNITS

≤0.5 Bethesda Units

Day(s) Performed

Monday through Friday

Report Available

2 to 12 days

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

85240-Coagulation factor VIII assay

85246-von Willebrand factor antigen

85397-von Willebrand factor activity

85390-Technical interpretation

85245-von Willebrand factor ristocetin cofactor activity (if appropriate)

85247-von Willebrand factor multimer (if appropriate)

85335-Bethesda titer (if appropriate)

85335-Coagulation factor VIII inhibitor screen (if appropriate)

85390-26-Special coagulation interpretation (if appropriate)

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
F8IS Coag Factor VIII Assay Inhib Scrn,P No No
AVWPQ von Willebrand Disease Interp No No
VWFMP von Willebrand Factor Multimer, P Yes, (order VWFMS) No
RIST Ristocetin Cofactor, P No No
8BETH FVIII Bethesda Units, P No No