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Low Molecular Weight Heparin Anti-Xa

Anti-Factor Xa, Heparin anti Xa, LMWH

Test Codes

EPIC: LAB316

Department

Coagulation

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 B3.2% Sodium Citrate tube OR One Pediatric Light Blue-top Sodium Citrate tube (1.8mL)

TUBE MUST BE FULL.

Physician Office/Draw Specimen Preparation

For optimal results, 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 1 hour of collection. If transport within 1 hour is not possible, the following procedure must be followed for accurate results:

1. Centrifuge the capped tubes at 1500 x g for 15 minutes.
2. Transfer plasma with 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 into a screw cap, 5 ml, 75 x 13 mm, round base, polypropylene 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 (20-25°C or 68-77°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.

In-Lab Processing

Whole blood specimens must be processed as follows upon receipt in the Laboratory: 

1. Centrifuge the capped tubes at 1500 x g for 15 minutes.
2. Transfer plasma with 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 into a plastic tube.

4. Test or freeze specimen according to lab protocol.

Storage

Specimen Stability for Testing:

Whole Blood
Room Temperature (20-26°C or 68-78.8°F): 1 hour
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Platelet Poor Plasma (PPP)
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

Performed

Sunday – Saturday, 24 hours a day.
STAT results available within 1 hour of receipt in the Laboratory.

Routine results available within 4 hours of receipt in the Laboratory. 

Reference Range

Therapeutic Range: at 4 hour post subcutaneous injection.

• 0.6-1.0 U/mL, Twice daily dosing.
• 1.0-2.0 U/mL, Once daily dosing.

Test Methodology

Chromogenic (IL ACL TOP Series).

Interpretation

A positive result indicates that some form of heparin is present. Pharmacy Dosing Services provides consultative services and dosage guidelines for anticoagulant management.

Clinical Utility

This test used to quantitate heparin activity in anti Xa units. It can be used for monitoring low molecular weight (LMW) heparin therapy.

CPT Codes

85520

LOINC: 3271-4

Contacts

Last Updated

10/30/2024