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Test Code DDAVP Desmopressin (DDAVP) Challenge

Specimen and Container/Tube

Specimen Type: Plasma

Preferred Specimen: Light Blue Top Tube, 3.2% Sodium Citrate

Other Acceptable specimens: N/A

Specimen Handling and Transport Instructions

UCMC Onsite Instructions: 

Collect specimen per standard collection procedure and send to laboratory immediately. 

 

NOTE: Once each blue top tube is completely filled, gently invert the sample tube at least five times to ensure complete mixing of the contents.

 

UCMC Offsite and UC MedLab Outreach Instructions: 

  • Collect specimen per standard collection procedure.
  • Once each blue top tube is completely filled, gently invert the sample tube at least five times to ensure complete mixing of the contents.
  • Centrifuge specimens at >2500 x g for 10 minutes at room temperature.
  • Carefully remove plasma from cells using a plastic transfer pipette avoiding buffy coat.
  • Aliquot removed plasma into 3 plastic tubes containing a minimum of 1.0 mL of specimen in each tube.
  • Plasma samples must then be frozen at -20oC.
  • Once solidly frozen, they must be shipped on dry ice. Samples that have thawed in transit will be rejected.

 

Rejection Criteria

  • Common specimen rejected situations include: incorrect specimen type, insufficient volume, missing or incomplete specimen identifiers, incorrect specimen transport, or specimens outside stability limits. 
  • Specimens that have wrong ratio of blood to anticoagulant (fill volume), clotted or grossly hemolyzed.

Reference Values

 

Test

Age

Sex

Reference Range

Factor VIII Activity (FA8)

All

All

57-152%

VWF Antigen Level (VWAG)

All

All

55-200%

vWF, GpIb Binding (vWF:GpIbM)

 (VWFGPIBM)

All

All

50-203%

VWF Collagen Binding Activity (VWFCBA)

All

All

46-159%

Critical Values

Analyte

Unit

Low

High

Age

N/A

N/A

N/A

N/A

N/A

CPT Codes

85240X5, 85246X5, 85245X5, 83520X5

LOINC Codes

27816-8, 4680-5, 50377-1, 73978-9

Volume

Preferred Volume: 3.0 mL

 

Minimum Volume: 1.0 mL

Specimen Stability

Storage Temperature

Stability

Room temperature

4 hours

Refrigerated

not acceptable

Frozen

30 days

Collection Instructions

Collect specimen per standard laboratory collection procedures. 

NOTE: Once each blue top tube is completely filled, gently invert the sample tube at least five times to ensure complete mixing of the contents.

Collect a baseline specimen prior to DDAVP administration, and 30 minutes, 1 hour, 2 hour, 4 hour specimens post DDAVP administration.

Each time point includes the following assays:

1. Factor VIII Coagulant Activity: test run 7 days a week from 8:00 am to 10:30 pm. Samples received in the lab after 10:30 pm will be run the next morning.

2. vWF, Antigenic Activity: test run 7 days a week from 8:00 am to 10:30 pm. Samples received in the lab after 10:30 pm will be run the next morning.

3. vWF, GpIb Binding (vWF:GpIbM):Tuesday and Thursday, day shift only. 

4. vWF, Collagen Binding Activity: Tuesday and Thursday, day shift only.

 

Please consult Lab medicine resident on-call (pager 7910) if more rapid test performance is deemed necessary.

Test Components

  • Factor VIII Activity (FA8),
  • VWF Antigen Level (VWAG).
  • vWF, GpIb Binding (vWF:GpIbM) (VWFGPIBM).
  • VWF Collagen Binding Activity (VWFCBA).
  • Pathologist interpretation of abnormal results.

NOTE: von Willebrand Factor Multimeric Analysis will also be included if required by pathologist for diagnosis.

Clinical Indications

Diagnosis and management of von Willebrand disease

Methodology

  • Factor VIII Activity (FA8): Clotting
  • VWF Antigen Level (VWAG): Immunoturbidimetric (latex immunoassay)
  • vWF, GpIb Binding (vWF:GpIbM) (VWFGPIBM): Immunoturbidimetric (latex immunoassay)
  • VWF Collagen Binding Activity (VWFCBA): ELISA

Additional Information

This package currently assesses both von Willebrand Factor (vWF) antigenic level and functional attributes. Functional attributes include an assessment of vWF interaction with platelets (specific antibody directed against the platelet binding site of vWF), interaction with collagen (assayed as collagen binding activity), and interaction with factor VIII (assayed as circulating factor VIII activity, each of which is also orderable individually if preferred.

 

 

If required for diagnosis by the pathologist, send-out testing for Multimeric Analysis will also be performed. As appropriate, recommendations for further specialized testing such as ristocetin-induced platelet aggregation or DNA analysis may also be made in individual cases, but the performance of such testing will require additional orders (and in the case of ristocetin-induced platelet aggregation, a separate blood draw on the day of testing).

 

3.2% sodium citrate light blue top tubes must have 9 to 1 ratio of blood to anticoagulant.

Turnaround Time

Turnaround times are relative to the time the specimen is received in the test laboratory. 

STAT Turnaround Time: N/A

 

Routine Turnaround Time: up to 4 days

 

Testing Schedule: Tuesday and Thursday, day shift only.

 

Please consult Lab medicine resident on-call (pager 7910) if more rapid test performance is deemed necessary.

Synonyms/Keyword Search

vWD Panel, von Willebrand Factor, vWF, vWF Disease

Last Review Date

10/30/2024