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Beaumont Laboratory

Quantitative D Dimer

D-dimer, Quantitative, EPIC: LAB5175 , SOFT: DIMER

Instructions

Specimens with hematocrit values greater than 55% must have anticoagulant adjusted. Specimens must be re-collected using a specified whole blood to sodium citrate ratio. Contact the performing Laboratory for specific instructions.

Specimen Collection Criteria

Collect: One Light Blue-top Becton-Dickinson 3.2% Sodium Citrate tube.

TUBE MUST BE FULL.

Physician Office/Drawsite Specimen Preparation

Maintain whole blood specimen at room temperature (20-26°C or 68-78.8°F) prior to transport. Transport whole blood to the Laboratory within 4 hours of collection. If transport within 4 hours is not possible, the following procedure must be followed for accurate results:

  1. Centrifuge the capped tube at 1500 x g for 15 minutes.
  2. Transfer plasma with a plastic pipette into a plastic polypropylene centrifuge tube, cap and centrifuge an additional 15 minutes at 1500 x g to obtain platelet poor plasma (PPP) which has a platelet count less than 10 bil/L. Plasma with a platelet count of less than 10 bil/L is critical for accurate results.
  3. Immediately remove only the top two-thirds of the PPP and transfer it into a plastic tube.
  4. Freeze (-20°C/-4°F or below) the PPP immediately.
  5. Transport frozen on DRY ICE. Specimen must remain frozen during transport. 

Preparation for Courier Transport

Transport: Whole blood at room temperature (20-26°C or 68-78.8°F), or plasma obtained through the process listed above, frozen (-20°C/-4°F or below).

Rejection Criteria

  • Glass tubes and 3.8% Sodium Citrate tubes.
  • Specimens that are clotted or grossly hemolyzed.
  • Inappropriate specimen volume.
  • Thawed or partially thawed specimens.

Storage

Specimen Stability for Testing:

Farmington Hills & Royal Oak
Room Temperature (20-26°C or 68-78.8°F): 4 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Plasma aliquot must be frozen for transport.

Grosse Pointe & Troy
Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Plasma aliquot must be frozen for transport.

Specimen Storage in Department Prior to Disposal:

Farmington Hills
Refrigerated (2-8°C or 36-46°F): 48 hours

Royal Oak, Grosse Pointe & Troy
Refrigerated (2-8°C or 36-46°F): 7 days*

*NOTE: A new sample is required in order for add-on testing. 

Laboratory

Farmington Hills Hematology/Coagulation Laboratory
Grosse Pointe Hematology/Coagulation Laboratory.
Royal Oak Coagulation Laboratory.
Troy Hematology/Coagulation Laboratory.

Performed

Sunday - Saturday, 24 hours a day.
Farmington Hills: Results available within 1 hour of receipt in the Laboratory.
Royal Oak: Results available within 45 minutes of receipt in the Laboratory.
Grosse Pointe & Troy: STAT results available within 45 minutes of receipt in the Laboratory. Routine results available within 90 minutes. 

Reference Range

Royal Oak, Grosse Pointe & Troy

VENOUS THROMBOEMBOLISM EXCLUSION (DVT/PE)

A cutoff value of ≤499 ng/ml F.E.U, can be used to exclude venous thromboembolism in patients with low clinical probability.

REFERENCE RANGE AND EVALUATION OF OTHER CONDITIONS (e.g. DIC)

For patients being evaluated for conditions other than DVT/PE, values of 0-499 ng/ml F.E.U may be considered normal and 500-580 may be considered equivocal. The normal and equivocal ranges were developed using subjects who were not screened or tested for DVT/PE, and their use should be limited to the evaluation of other appropriate medical conditions (i.e., DIC, liver dysfunction, etc.

Farmington Hills

VENOUS THROMBOEMBOLISM EXCLUSION (DVT/PE)

Using a cutoff value of <230 D-DU ng/ml, the negative predictive value (the exclusion) of VTE is >99% for patients who clinically grade as low to moderate risk.

REFERENCE RANGE AND EVALUATION OF OTHER CONDITIONS (e.g. DIC)

For patients being evaluated for conditions other than DVT/PE, values of 0-316 D-DU may be considered normal. The normal range was developed using subjects who were not screened or tested for DVT/PE, and its use should be limited to the evaluation of other appropriate medical conditions (i.e., DIC, liver dysfunction, etc.).

Test Methodology

Farmington Hills & Royal Oak: Immuno-turbidimetric assay.
Grosse Pointe & Troy:
Enzymed-linked Fluorescent immunoassay (ELFA) performed on a Vidas 3 instrument.

Interpretation

The quantitative D-dimer is a very sensitive assay for detecting thrombosis with secondary fibrinolysis. A positive quantitative D-dimer can be found in a number of conditions associated with thrombin generation including thromboembolism, disseminated intravascular coagulation (DIC), infectious or inflammatory disorders, malignancy, post-operative wound healing, and during pregnancy/post-partum.

Clinical Utility

See reference range section above.

CPT Code

85379.

Test Codes

EPIC: LAB5175 , SOFT: DIMER

Last Updated

08/14/2017

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This directory currently reflects information only for specimens collected and/or processed at the Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.