Laboratory: Hematology
Test Name:
ADAMTS13 ACTIVITY AND INHIBITOR PROFILE - (P)
Test Code: ADAM
Clinical Information:
Test performed at:  St. Michaels Hospital, Toronto Ontario
Restricted to Nephrologists and Hematologists, or via Hematopathologist Approval. 

Must collect prior to initiating plasma exchange.

Test Indications: It’s essential for  the diagnosis of congenital or acquired TTP (thrombotic thrombocytopenic purpura). Less than 10% ADAMTS-13 activity is highly indicative of TTP in an appropriate clinical setting. TTP is a medical emergency (untreated has nearly 100% mortality and treated in a timely manner has a >90% survival rate), which requires prompt diagnosis, and costly plasma exchange for the patient.

 
Collection Devices:
Specimen Required:
Whole Blood: 4.4 mL
Pediatric Whole Blood: 3.6 mL

Sample must be sent to the lab immediately.

Double spin of plasma required in three (3) separate aliquots. Transfer top two thirds of plasma from collection tube to a new plastic tube.  Re-centrifuge and then remove the top two thirds of plasma and place into a new plastic tube.  Cap and freeze immediately in three (3) separate aliquots. 

For best results, centrifuged and separated within 60 minutes of collection.
Referral:
Plasma: 2.0 mL
Pediatric Plasma: 1.0 mL

  1. WRHA: Refer frozen plasma to HSC Central Services on a stat basis, including during weekends.
  2. Outside WRHA: Refer frozen plasma to HSC Central Services on the next courier run.
  3. Sample collection, processing, and referal to HSC Central Services must proceed without delay, regardless of the ordering provider. 

    Referred Out Location: St. Michaels, Toronto Ontario
    Must be shipped and remain frozen with dry ice.
    Freeze plasma immediately at -20°C (-80°C preferred).
    One (1) aliquot is retained at HSC Central Services where volume permits. 
     
Requisition:
Reference Values:
See report. Report will be faxed to ordering provider.
Availability:
Daily
Test must be approved by the Hematopathologist on service, except Nephrologists and Hematologists.
See Also:
More Information:
  1. WRHA: Refer frozen plasma to HSC Central Services on a stat basis, including during weekends.
  2. Outside WRHA: Refer frozen plasma to HSC Central Services on the next courier run.
  3. Sample collection, processing, and referral to HSC Central Services must proceed without delay, regardless of the ordering provider. 


For HSC Central Services for referral to St. Michaels: 

Delivery: Monday to Friday.  Thawed OR unlabeled samples will be REJECTED for testing. Specimens cannot be shipped on Friday, holidays, weekends.  Minimum plasma volume: 0.5 mL.  Inhibitor studies will be reflexed automatically when Activity is </=10%.