Test Code APROL Prolonged Clot Time 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 the 5 aliquots in the same shipping container.
Necessary Information
Note if patient is currently receiving heparin, Coumadin (warfarin) or any medication affecting coagulation.
Specimen Required
Specimen Type: Platelet-poor plasma
Patient Preparation:
1. Patient should not be receiving anticoagulant treatment (eg, warfarin, heparin). Treatment with heparin causes false-positive results of in vitro coagulation testing for lupus anticoagulant. Coumadin (warfarin) treatment may impair ability to detect the more subtle varieties of lupus-like anticoagulants.
2. Patient should also not be receiving fibrinolytic agents (streptokinase, urokinase, tissue plasminogen activator [tPA]).
3.It is best to perform this study pretransfusion if possible. If patient has been recently transfused, wait at least 48 hours after transfusion to collect the specimen.
Collection Container/Tube: Light-blue top (3.2% sodium citrate)
Submission Container/Tube: Plastic vial
Specimen Volume: 5 mL in 5 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 5 separate plastic vials leaving 0.25 mL in the bottom of centrifuged vial.
5. Freeze plasma immediately (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.
Forms
1. Coagulation Patient Information (T675)
2. If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.
Useful For
Determining the cause of prolongation of prothrombin time or activated partial thromboplastin time
Screening for prolonged clotting times and determining the presence of factor deficiencies or inhibitor (eg, factor-specific, lupus-like, or the presence of heparin)
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
APRI | Prolonged Clot Time Prof Interp | No | Yes |
PTSC | Prothrombin Time (PT), P | Yes, (order PTTP) | Yes |
APTSC | Activated Partial Thrombopl Time, P | Yes, (order APTTP) | Yes |
DRV1 | Dilute Russells Viper Venom Time, P | Yes, (order DRVI1) | Yes |
TTSC | Thrombin Time (Bovine), P | Yes | Yes |
CLFIB | Fibrinogen, Clauss, P | Yes, (order FIBTP) | Yes |
DIMER | D-Dimer, P | Yes, (order DDITT) | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
GBETH | General Factor Bethesda Units, P | No | No |
5BETH | FV Bethesda Units, P | No | No |
8BETH | FVIII Bethesda Units, P | No | No |
9BETH | FIX Bethesda Units, P | No | No |
F8IS | Coag Factor VIII Assay Inhib Scrn,P | No | No |
FACTV | Coag Factor V Assay, P | Yes | No |
F_7 | Coag Factor VII Assay, P | Yes | No |
F_9 | Coag Factor IX Assay, P | Yes | No |
F_10 | Coag Factor X Assay, P | Yes | No |
F_11 | Coag Factor XI Assay, P | Yes | No |
F_12 | Coag Factor XII Assay, P | Yes | No |
F8A | Coag Factor VIII Activity Assay, P | Yes | No |
RTSC | Reptilase Time, P | Yes | No |
F_2 | Coag Factor II Assay, P | Yes | No |
PNP | Platelet Neutralization Procedure | No | No |
PTMSC | PT Mix 1:1 | No | No |
APMSC | APTT Mix 1:1 | No | No |
DRV2 | DRVVT Mix | No | No |
DRV3 | DRVVT Confirmation | No | No |
F5_IS | Factor V Inhib Scrn | No | No |
F9_IS | Factor IX Inhib Scrn | No | No |
F2_IS | Factor II Inhib Scrn | No | No |
F7_IS | Factor VII Inhib Scrn | No | No |
10_IS | Factor X Inhib Scrn | No | No |
11_IS | Factor XI Inhib Scrn | No | No |
PTFIB | PT-Fibrinogen, P | No | No |
SOLFM | Soluble Fibrin Monomer | No | No |
CH9 | Chromogenic FIX, P | Yes | No |
CHF8 | Chromogenic FVIII, P | Yes | No |
HEXLA | HEX LA, P | No | No |
Special Instructions
Method Name
ARPI: Medical Interpretation
PTSC, APTSC, DRV1, TTSC, GBETH, 5BETH, 8BETH, 9BETH, F8IS, FACTV, F_2, F_7, F_9, F_10, F_11, F_12, F8A, RTSC, PNP, APMSC, PTMSC, PTFIB, DRV2, DRV3: Optical Clot-Based
CLFIB: Clauss
DIMER, SOLFM: Latex Immunoassay (LIA)
CH9, CHF8: Chromogenic
HEXLA: Spectrophotometric
Reporting Name
Prolonged Clot Time ProfSpecimen Type
Plasma Na CitSpecimen Minimum Volume
4 plastic vials, each containing 1 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Plasma Na Cit | Frozen | 14 days |
Reject Due To
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Clinical Information
When coagulation screening tests are performed to verify normal function of the coagulation system (eg, preoperative, routine examination), they sometimes indicate an abnormality that may be unexplained (ie, prolonged clotting times). This consultation provides validation of the prolongation and as comprehensive a workup as needed to define the abnormality.
Possibilities for a cause of prolongation include:
-Artifactual due to high hematocrit (dilution of specimen by anticoagulant if patient hematocrit is 55% or greater)
-Factor deficiencies, congenital or acquired
-Factor inhibitors eg, factor VIII inhibitors (bleeding disorder)
-Lupus anticoagulant (risk for thrombosis or recurrent miscarriage)
-Anticoagulant drug effect eg, (including warfarin [Coumadin or Jantoven], oral anti-Xa inhibitors, oral direct thrombin inhibitors), heparin.
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Friday
Report Available
3 to 7 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
See Individual Test IDsCPT Code Information
85379-DIMER
85384-CLFIB
85390-26-APRI
85610-PTSC
85613-DRV1
85670-TTSC
85730-APTSC
85130-Chromogenic FVIII (if appropriate)
85130-Chromogenic FIX (if appropriate)
85210-Factor II (if appropriate)
85220-Factor V (if appropriate)
85230-Factor VII (if appropriate)
85240-Factor VIII (if appropriate)
85250-Factor IX (if appropriate)
85260-Factor X (if appropriate)
85270-Factor XI (if appropriate)
85280-Factor XII (if appropriate)
85335-Bethesda titer (if appropriate)
85335-Factor V inhibitor screen (if appropriate)
85335-Factor VIII inhibitor screen (if appropriate)
85335-Factor IX inhibitor screen (if appropriate)
85366-Soluble fibrin monomer (if appropriate)
85385-PT-Fibrinogen (if appropriate)
85597-Platelet neutralization for lupus inhibitor (if appropriate)
85598-Hex LA (if appropriate)
85611-PT mix 1:1 (if appropriate)
85613-DRVVT mix (if appropriate)
85613-DRVVT confirm (if appropriate)
85635-Reptilase time (if appropriate)
85732-APTT mix 1:1 (if appropriate)