Diagnosing congenital deficiencies (rare) of coagulation factor V
Evaluating acquired deficiencies associated with liver disease, factor V inhibitors, myeloproliferative disorders, and intravascular coagulation and fibrinolysis
Investigation of prolonged prothrombin time or activated partial thromboplastin time
Optical Clot-Based
FACTOR V ACTIVITY
Plasma Na Cit
Coagulation testing is highly complex, often requiring the performance of multiple assays and correlation with clinical information. For that reason, consider ordering a Coagulation Consultation.
If priority specimen, mark request form, give reason, and request a call-back.
Patient Preparation: Patient must not be receiving coumadin (warfarin) or heparin therapy. (If not possible for medical reasons, note on request.)
Collection Container/Tube: Light-blue top (3.2% sodium citrate)
Specimen Type: Platelet-poor plasma
Collection Container/Tube: Light-blue top (3.2% sodium citrate)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Specimen must be collected prior to factor replacement therapy.
2. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing
3. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.
4. Aliquot plasma into a plastic vial, leaving 0.25 mL in the bottom of centrifuged vial.
5. Freeze plasma immediately (no longer than 4 hours after collection) at -20 degrees C or, ideally, -40 degrees 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.
If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.
0.5 mL
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Plasma Na Cit | Frozen | 14 days |
Diagnosing congenital deficiencies (rare) of coagulation factor V
Evaluating acquired deficiencies associated with liver disease, factor V inhibitors, myeloproliferative disorders, and intravascular coagulation and fibrinolysis
Investigation of prolonged prothrombin time or activated partial thromboplastin time
Factor V is a vitamin K-independent protein synthesized in the liver and in other tissues (endothelium, megakaryocytes/platelets). In its thrombin-activated form (factor Va), it serves as an essential cofactor in the prothrombinase enzyme complex, which converts prothrombin to thrombin (the prothrombinase complex consists of the enzyme, activated factor X, factor Va cofactor, a phospholipid surface, and calcium).
Deficiency of factor V may cause prolonged prothrombin time and activated partial thromboplastin time and may result in a bleeding diathesis. Plasma biological half-life varies from 12 to 36 hours.
Platelets contain 20% to 25% of the factor V in blood. Factor V (also known as labile factor) is highly susceptible to proteolytic inactivation, with the potential for spuriously decreased assay results.
>1 month: 70%-165%
<1 month: Normal, full-term and premature newborn infants may have mildly decreased levels (> or =30% to 35%) which reach adult levels within 21 days postnatal.
*See Pediatric Hemostasis References section in Coagulation Guidelines for Specimen Handling and Processing
Acquired deficiencies are much more common than congenital.
Patients that are congenitally deficient homozygous generally have activity levels less than or equal to10% to 20%.
Patients that are congenitally deficient heterozygous generally have activity levels less than or equal to 50%.
Congenital deficiency may occur in combined association with factor VIII deficiency.
Factor V (labile factor) is highly susceptible to proteolytic inactivation, with the potential for spuriously decreased assay results. In normal individuals, after freeze-thaw of citrate plasma, factor V activity typically may be 10% to 20% less than observed in a fresh plasma specimen, and
1. Girolami A, Scandellari R, Scapin M, Vettore S. Congenital bleeding disorders of the vitamin K-dependent clotting factors. Vitam Horm. 2008;78:281-374
2. Brenner B, Kuperman AA, Watzka M, Oldenburg J. Vitamin K-dependent coagulation factors deficiency. Semin Thromb Hemost. 200935(4):439-446
3. Asselta R, Peyvandi F. Factor V deficiency. Semin Thromb Hemost. 200935(4):382-389
4. Lippi G, Favaloro EJ, Montagnana M, et al: Inherited and acquired factor V deficiency. Blood Coagul Fibrinolysis. 2011 Apr;22(3):160-166
5. Spreafico M, Peyvandi F. Combined FV and FVIII deficiency. Haemophilia. 2008;14(6):1201-1208
6. Kottke-Marchant K, ed: Laboratory Hematology Practice. Wiley Blackwell Publishing; 2012
7. Favaloro EJ and Lippi G. eds. Hemostasis and Thrombosis, Methods and Protocols. Humana Press 2017
The factor V assay is performed on the Instrumentation Laboratory ACL TOP using the prothrombin time (PT) method and a factor-deficient substrate. Patient plasma is combined and incubated with a factor V-deficient substrate (normal plasma depleted of factor V by immunoadsorption). After a specified incubation time, a PT reagent is added to trigger the coagulation process in the mixture. Then the time to clot formation is measured optically at a wavelength of 671 nm.(Owen CA Jr, Bowie EJW, Thompson JH Jr: Diagnosis of Bleeding Disorders. 2nd ed. Little, Brown and Company; 1975; Meijer P, Verbruggen HW, Spannagi M: Clotting factors and inhibitors: Assays and interpretation. In: Kottke-Marchant K, ed. Laboratory Hematology Practice. Wiley Blackwell Publishing; 2012:435-446)
Monday through Saturday
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
85220
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
FACTV | Coag Factor V Assay, P | 3193-0 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
FACTV | Coag Factor V Assay, P | 3193-0 |