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DDAVP (Desmopressin) Panel, Pre- and Post-Trial

Test Codes

For Platelets: EPIC: LAB1231132
Answer the order question regarding Pre or Post DDAVP Specimen.

For Von Willebrand Disease: EPIC: LAB1231763 (Von Willebrand Disease Panel Drug Monitoring)
Answer the order question regarding Pre or Post DDAVP Specimen.

Department

Coagulation

Instructions

• Patients with von Willebrand Disease or qualitative platelet disorders may require a trial of DDAVP prior to invasive procedures. Corewell Health Laboratory has arranged a protocol to facilitate these trials. The Pre- and Post-Trial DDAVP Panel includes:
• DDAVP Trial for von Willebrand Disease (Factor VIII Activity, von Willebrand Factor Activity, and von Willebrand Factor Antigen).
• DDAVP Trial for Platelets (Platelet Function Analysis).
• Arrangements for the time and place of specimen collection must be made by the ordering physician. It is recommended that specimens be collected at a Corewell Health Hospital campus location.

Specimen Collection Criteria

Collect: Five Light Blue-top 3.2% Sodium Citrate tubes.

• TUBES MUST BE FULL.
• Three Light Blue-top tubes are to be used for von Willebrand Disease Panel. Two Light Blue-top tubes are to be used for Platelet Function Analysis.
• The specimen must be identified as Pre-DDAVP or Post-DDAVP on the requisition or documented in the computer system.

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. 

In-Lab Processing

Specimens for Platelet Function Analysis (two tubes) must not be refrigerated, frozen, or centrifuged. PFA specimens must be analyzed within 3 hours of collection.

Specimens for von Willebrand Disease Panel (three tubes) must be processed as follows 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 a screw cap, 5 ml, 75 x 13 mm, round base, polypropylene tube.

4. Test or freeze specimen according to lab protocol.

Storage

Specimen Stability for Testing:

Platelet Function Analysis Specimens
Room Temperature (20-26°C or 68-78.8°F): 3 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Whole Blood for von Willebrand Disease Panel
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): Unacceptable

Platelet Poor Plasma (PPP) for von Willebrand Disease Panel
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): 30 days

Specimen Storage in Department Prior to Disposal:

Frozen (-20°C/-4°F or below): 30 days

Laboratory

Royal Oak Coagulation Laboratory
Troy Coagulation Laboratory

Performed

Monday – Friday.
Results available in 4-7 business days. 

Reference Range

Von Willebrand Disease Panel
Factor VIII Activity: 50-175%
von Willebrand Factor Activity: 50-175%
von Willebrand Factor Antigen: 50-175%

Platelet Function Analysis
Collagen/Epinephire: Less than or equal to 160 seconds
Collagen/ADP: Less than or equal to 106 seconds 

Interpretation

In patients with mild von Willebrand or qualitative platelet abnormalities, DDAVP (desmopression) can normalize von Willebrand Antigen, von Willebrand Activity, Factor VIII Activity, and/or PFA results. Clinical correlation is necessary to determine if post-DDAVP changes are sufficient for the patient to undergo invasive procedures.

Clinical Utility

The DDAVP trial tests are used for patients with von Willebrand Disease and platelet disorders prior to invasive procedures.

CPT Codes

Factor VIII: 85240
VWFAG: 85246
VWFAC: 85397
PFA: 85576x2

LOINC:
Factor VIII: 3209-4
VWFAG: 27816-8
VWFAC: NA
PFA ADP: 24472-3
PFA EPI: 24471-5

Contacts

Last Updated

8/15/2024