Corewell Health Laboratory (Grand Rapids) Coagulation laboratory is pleased to announce a change to our von Willebrand factor (VWF) activity test. The historical test von Willebrand ristocetin cofactor (LAB335) will be retired and replaced by von Willebrand factor activity (VWF activity, LAB1230904) on January 17, 2023.
Effective December 6, 2021, Spectrum Health Reference Laboratory (SHRL) Coagulation department will go live with a new lot of Prothrombin Time (Protime/PT) reagents. The reference range for the PT will be adjusted to reflect this reagent lot change and align with our Regional Laboratories. The new reference range will be 9.5 – 12.0 seconds. There will be no change to the INR ranges.
|Test||Current Reference Range||New Reference Range|
|Prothrombin Time (PT)||9.7 – 12.6 seconds||9.5 – 12.0 seconds|
On Tuesday October 26, 2021, a new lot of aPTT reagent will go live for the Spectrum Health Laboratory Information System starting at 10:00 AM.
• The aPTT therapeutic range for ADULT patients on continuous heparin infusions will be updated to reflect the new reagents. The therapeutic range, for most indications, will be changed from 37 to 52 seconds to a new range of 42 to 57 seconds. UFH anti-Xa therapeutic ranges will remain unchanged (0.3 to 0.7 units/mL). All ADULT nomograms will be adjusted to reflect the new therapeutic ranges.
• For PEDIATRIC patients, aPTT nomograms will no longer be used in this population. Only the unfractionated heparin (UFH) anti-Xa nomograms will remain for PEDIATRIC patients, again with no changes made to their current UFH anti-Xa nomograms.
The Spectrum Health Laboratory Coagulation Department announces the following changes occurring on 6.29.21 because of new instrumentation:
• New coagulation instrumentation will go-live on 6.29.21.
• This new instrumentation will align the Spectrum Health Regional Laboratory (in GR) with current Regional/Blodgett reportable upper limit for Protime/INR results.
• The current Protime (PT) upper limit of 120 seconds will change to 90 seconds. Any result that is greater than 90 seconds, will be reported as >90 seconds.
• The current INR upper limit of 12.0 will change to 8.0. Any result that is greater than 8.0 will be reported as >8.0.
Any questions can be directed to the Spectrum Health Regional Laboratory Coagulation Department using the Contact Us link above.
PT/INR (Protime with INR): Epic Code #LAB320 | Interface code #10059 | CPT #85610
Effective July 1, 2021, the Coagulation Department within the Spectrum Health Regional Laboratory will go live with an in-house, bovine based, Chromogenic Factor VIII assay.
This assay, a photometric determination of Factor VIII activity, is useful for monitoring coagulation factor replacement therapy of selected extended half-life coagulation factor replacements and Emicizumab therapy, a recombinant, monoclonal antibody that restores the function of the missing activated factor VIII by bridging FIXa and FX. The action of Emicizumab interferes with all APTT clot based and human chromogenic based assays, leading to an overestimation of Factor VIII activity. As such, the bovine based Chromogenic Factor VIII assay is recommended. The Chromogenic Factor VIII activity also assists in the diagnosis of hemophilia A using a 2-stage assay, particularly when the 1-stage clot based assay is normal.
For questions about this test, please refer to the laboratory catalog or use the Contact Us link above.
Chromogenic Factor VIII Activity – Epic Code: LAB1230831 | Interface Code: 1230831 | CPT: 85240
Coagulation Blue Top Tube Shortage
September 1, 2021
There continues to be a global shortage of sodium citrate (“blue top”) blood collection tubes used for coagulation testing as a result of unprecedented demand, in part due to COVID-19 surges, vaccine and treatment development. This was anticipated to last through August 2021, but now, due to continued unprecedented demands, there is no end date in sight. Please take this into consideration when ordering coagulation testing (i.e. Protime, aPTT, Fibrinogen, D-dimer, Lupus Screens, Factor Assays, Mixing Studies, von Willebrand testing, etc.).
CSF Priorities on QNS Specimens
When a Cerebrospinal fluid (CSF) specimen arrives into the laboratory and is deemed Quantity Not Sufficient (QNS) for ordered testing, the ordering provider is contacted to identify testing priorities. Occasionally, the laboratory is unable to secure these priorities.
If the lab is unable to secure priorities from the ordering provider within an hour of collection, the following will occur:
1. We will move forward with the Cell count with differential, Culture, and Protein/Glucose
2. The rest of the ordered testing will hold until we can clarify the priorities
Laboratory is partnering with Epic Beaker to discover if a prioritization of orders, upon CSF order entry, is possible.
If you have questions or concerns, please use the “Contact Us” link above.
Supply Change Notification: 4.5 mL Blue Citrate Blood Tubes
Effective April 26th, 2021, Spectrum Health Laboratories will discontinue 4.5 mL blue citrate blood tubes. These are a vendor discontinued item. The replacement item will be the 2.7 mL blue citrate blood tubes.
Due to this change, there may be a difference in the number of tubes required to collect for the lab tests below. Please refer to the lab catalog for specimen collection requirements.