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Dabigatran, Plasma

Test Codes

EPIC: LAB6885, Beaker: XMISC, Mayo: DABIE

Department

Send Outs

Instructions

Specimen should be drawn 1 to 3 hours (peak) after a dose or just prior (trough) to the next dose for dabigatran concentrations.

Specimen Collection Criteria

Collect: Two Light Blue-top Sodium Citrate tubes.

Physician Office/Draw Specimen Preparation

For optimal results, maintain whole blood sodium citrate specimens 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 five plastic tubes.
4. Freeze (-20°C/-4°F or below) the PPP specimens immediately.
5. Transport frozen on DRY ICE. Specimen must remain frozen during transport.

Preparation for Courier Transport

Transport: 1.0 mL plasma, frozen (-20°C/-4°F or below). (Minimum: 0.5 mL)

Rejection Criteria

• Specimens collected in EDTA.
• Specimens not collected and processed as indicated.

In-Lab Processing

Specimens must be processed immediately upon receipt in the Laboratory:

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 five plastic tubes.
4. Freeze (-20°C/-4°F or below) the PPP specimens immediately.

Transport: 1.0 mL plasma, frozen (-20°C/-4°F or below). (Minimum: 0.5 mL) 

 

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): 42 days

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to Mayo Clinic Laboratories in Rochester, MN.

Performed

Monday – Friday.
Results available in 4-6 days.

Reference Range

By report.

Test Methodology

Chromogenic assay.

Interpretation

Useful in measuring dabigatran concentration in plasma.

This assay is not useful for measurement of other direct thrombin inhibitors e.g., argatroban or bivalirudin.

Clinical Utility

Dabigatran, an oral direct thrombin inhibitor (DTI) that directly inhibits factor IIa, is indicated for use in patients with nonvalvular atrial fibrillation and venous thromboembolism. Dabigatran is administered orally twice daily, is eliminated primarily through the renal system, and can inhibit both soluble and clot-bound thrombin. Dabigatran does not require routine therapeutic monitoring. However, in selected clinical situations, measurement of drug level would be useful, e.g., renal insufficiency, assessment of compliance, periprocedural, suspected overdose, advanced age, and extremes of body weight.

CPT Codes

80299

Contacts

Last Updated

7/21/2024