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Hemostasis/Coagulation

Hemostasis/Coagulation, Test Spotlight

New Reference Range: APTT and APTT Assay

Beginning September 8, at approximately 2PM, Spectrum Health Laboratories will go live with their new lot of APTT reagent.  This lot change triggered a new therapeutic curve resulting in new heparin nomograms for the system.  The standard heparin therapeutic range will change from the current 45-65 seconds to a new range of 37-52 seconds based off the new curve.  Reference ranges for the APTT assay will also be updated.  Grand Rapids APTT reference range will be 21-27 seconds and the Regional Hospitals will be 21-31 seconds.

APTT specimens that are unable to reach an endpoint (no clot is detected), will reflex to the Unfractionated Heparin (UFH) (Test Code LAB3389) anti-Xa assay.  To accommodate this change, UFH values have been added to heparin nomograms. The UFH anti-Xa assay is currently only performed in the Grand Rapids labs and valid only for unfractionated heparin.  Any questions concerning these changes may be directed to the Spectrum Health Regional Laboratory Coagulation department at 616-267-2740.

General Information, Hemostasis/Coagulation

Test Update: D-Dimer

Effective April 30, 2020, Spectrum Health Laboratories will no longer be performing the D-Dimer Semi-Quantitative assay. D-Dimer (quantitative) will be the only orderable for the D-Dimer assay. This D-Dimer will be reportable up to 35,000 ng/mL FEU. The cut-off value used in the diagnosis of venous thromboembolism (VTE), deep vein thrombosis (DVT), or pulmonary embolism (PE) remains at 500 ng/mL FEU. It is important to note inpatients can be (falsely) elevated in many underlying non-thrombotic conditions common in hospitalized patients.

Questions and inquiries regarding this change may be sent to the Coagulation Department using the “Contact Us” link above.

 

TEST INFORMATION

D-Dimer – [Epic Code: LAB313, Interface Code: 10123, CPT 85379]

Discontinued: D-Dimer Semiquantitative for DIC [Epic Code: LAB760, Interface Code: 10122, CPT: 85378]

Hemostasis/Coagulation

New Test: Thrombin Time

Effective March 4th, 2020, Thrombin Time will change from a sendout reference test performed by Mayo Clinic Laboratories to an in-house test performed by Spectrum Health Regional Laboratory. This test will be performed in the Coagulation Laboratory and will include a new reference range (please see link in Test Information below).

Thrombin Time is suitable for monitoring fibrinolysis therapy, screening for disorders of fibrin formation and in cases of suspected fibrinogen deficiency states. It is also useful for the differentiation between a heparin induced prolongation of the thrombin time and fibrin formation disorders.

For questions around this test, please contact the Coagulation Department at 616-267-2740.

TEST INFORMATION

Thrombin Time – Epic Code: #LAB11230581, Interface Code: #11230581, CPT: #85670