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Laboratory: Hematology
Test Name:
ADAMTS13 ACTIVITY AND INHIBITOR PROFILE - (P)
Test Code: ADAM
Clinical Information:
Test performed at:  St. Michaels Hospital, Toronto Ontario
PRIOR APPROVAL required, except Nephrologists and Hematologists.

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.

    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.


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%.
 
Lab Information Manual 2.10.0
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