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Quantitative D Dimer

D-dimer, Quantitative

Test Codes

EPIC: LAB5175, LAB03858, SOFT: DIMER, Sunquest: DIMEI

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 3.2% Sodium Citrate tube.

TUBE MUST BE FULL.

Physician Office/Draw 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 8 hours of collection. If transport within 8 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 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 (20-26°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.

In-Lab Processing

Whole blood specimens 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 plastic tube.

4. Test or freeze specimen according to lab protocol.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 8 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
Room Temperature (20-26°C or 68-78.8°F): 7 days
Refrigerated (2-8°C or 36-46°F): 7 days*

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

Laboratory

Dearborn Hematology/Coagulation Laboratory
Farmington Hills Hematology/Coagulation Laboratory
Grosse Pointe Hematology/Coagulation Laboratory
Lenox Main Laboratory
Livonia Main Laboratory
Royal Oak Coagulation Laboratory
Troy Hematology/Coagulation Laboratory
Taylor Hematology/Coagulation Laboratory
Trenton Hematology/Coagulation Laboratory
Wayne 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. 
Dearborn, Taylor, Trenton & Wayne: Results available within 30 minutes of receipt in the STAT Laboratory. Routine results available within 2 hours.

Reference Range

Venous Thromboembolism Exclusion (DVT/PE)
A cutoff value of <500 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 <600 ng/ml F.E.U may be considered normal. The normal 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

Immuno-Turbidimetric Assay (IL ACL-TOP Series).

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 Codes

85379

Contacts

Last Updated

5/19/2022