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Test Code LAB4095 von Willebrand Factor Multimer Analysis, Plasma

Additional Codes

SQ: VWFM2M

MAYO: VWFMS

 


Ordering Guidance


Coagulation testing is highly complex, often requiring the performance of multiple assays and correlation with clinical information. For that reason, we suggest ordering AVWPR / von Willebrand Disease Profile, Plasma.



Additional Testing Requirements


VWACT / von Willebrand Factor Activity, Plasma and VWAG / von Willebrand Factor Antigen, Plasma are requested but not required before performing this test. If already assayed, submit results. If no results are included, submit separate specimens for the above assays following specimen requirements for each test.



Specimen Required


Specimen Type: Platelet-poor plasma

Patient Preparation:

1. Fasting is preferred.

2. Specimen should be collected prior to coagulation factor replacement therapy.

Collection Container/Tube: Light-blue top (3.2% sodium citrate)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing.

2. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.

3. Aliquot plasma into a plastic vial leaving 0.25 mL in the bottom of centrifuged vial.

4. Freeze plasma immediately (no longer than 4 hours after collection) at -20° C or, ideally, -40° C or below.

Additional Information:

1. Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.

2. Each coagulation assay requested should have its own vial.


Forms

1. Coagulation Patient Information (T675)

2. If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.

Secondary ID

603851

Useful For

Resolving discrepancies when results of complementary laboratory tests (eg, F8A / Coagulation Factor VIII Activity Assay, Plasma; VWACT / von Willebrand Factor Activity, Plasma; and VWAG / von Willebrand Factor Antigen, Plasma) are abnormally low or discordant

 

Subtyping von Willebrand disease (VWD) (primarily identify variants of type 2 VWD)

 

Aiding in determining appropriate treatment

 

Identifying variants of type 2 VWD that have fewer of the largest multimers, have unusually large multimers, or have qualitatively abnormal "bands" that indicate an abnormal von Willebrand factor structure

Method Name

Agarose Gel Electrophoresis/Infrared Dye-Labeled Antibody Detection

Reporting Name

von Willebrand Factor Multimer, P

Specimen Type

Plasma Na Cit

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Na Cit Frozen 42 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Reference Values

An interpretive report will be provided.

Method Description

Platelet-poor plasma proteins are denatured using heat and an anionic detergent, sodium dodecyl sulfate. The sample is then electrophoresed through a discontinuous agarose gel on a cooled horizontal electrophoresis unit overnight to separate the von Willebrand factor (VWF) multimers by size. The gel is fixed in acid and isopropanol, washed in water, and incubated with dilute rabbit-antihuman VWF. After washing away unbound antibody, the gel is incubated with dilute goat-antirabbit IgG antibody tagged with an infrared dye. Excess secondary antibody is washed away, and the gel is scanned using an infrared imaging system. The digitized image of the electrophoretic distribution of the VWF multimers is interpreted by a coagulation consultant and a written report is provided.(Favaloro EJ, Koutts J: Diagnosis of von Willebrand disease. In: Kottke-Marchant K, ed. Laboratory Hematology Practice. Wiley Blackwell; 2012:447-459; Favaloro EJ and Lippi G. eds. Hemostasis and Thrombosis, Methods and Protocols. Humana Press 2017)

Day(s) Performed

Monday through Thursday

Report Available

7 to 14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

85247

LOINC Code Information

Test ID Test Order Name Order LOINC Value
VWFMS von Willebrand Factor Multimer, P 48595-3

 

Result ID Test Result Name Result LOINC Value
603851 von Willebrand Factor Multimer, P No LOINC Needed
603855 VWF Multimer Interpretation 48595-3