Protein S, Functional

TEST: 164525
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CPT: 85306
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Synonyms

  • Functional Protein S
  • Protein S Activity

Special Instructions

If the patient's hematocrit exceeds 55%, the volume of citrate in the collection tube must be adjusted. Refer to Coagulation Collection Procedures for directions.

Expected Turnaround Time

2 - 3 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Information

Related Documents

For more information, please view the literature below.

Procedures for Hemostasis and Thrombosis: A Clinical Test Compendium

Specimen Requirements

Specimen

Plasma, frozen

Volume

1 mL

Container

Blue-top (sodium citrate) tube

Collection

Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples, except when using a winged blood collection device (ie, "butterfly"), in which case a discard tube should be used.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze immediately and maintain frozen until tested.

Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

Storage Instructions

Freeze.

Stability Requirements

Temperature

Period

Frozen

28 days

Freeze/thaw cycles

Stable x3

Patient Preparation

Avoid warfarin (Coumadin®) therapy for two weeks and heparin therapy for two days prior to the test. Do not draw from an arm with a heparin lock or heparinized catheter.

Causes for Rejection

Gross hemolysis; clotted specimen; frozen specimen thawed in transit; improper labeling

Test Details

Use

This test is used for confirmation and characterization of protein S (PS) congenital deficiency.

Limitations

The presence of heparin or lupus anticoagulants leads to overestimation of PS. aPC resistance due to factor V Leiden mutation or some other cause can falsely lower measured PS activity levels.6

Methodology

The patient plasma is added to PS-depleted normal plasma with normal levels of all factors but PS. The mixture is supplemented with excess aPC and factor V is then added. The extent of prolongation of the time to clot formation after calcium chloride is added is proportional to plasma PS activity.

Additional Information

See Protein S Deficiency Profile [117754] for more clinical information.

Footnotes

1. Adcock DM, Kressin DC, Marlar RA. Effect of 3.2% vs 3.8% sodium citrate concentration on routine coagulation testing. Am J Clin Pathol. 1997; 107(1):105-110. 8980376
2. Reneke J, Etzell J, Leslie S, et al. Prolonged prothrombin time and activated partial thromboplastin time due to underfilled specimen tubes with 109 mmol/L (3.2%) citrate anticoagulant. Am J Clin Pathol. 1998; 109(6):754-757. 9620035
3. National Committee for Clinical Laboratory Standardization: Collection, Transport, and Processing of Blood Specimens for Coagulation Testing and General Performance of Coagulation Assays; Approved Guideline. 5th ed. Villanova, Pa: NCCLS; 2008. Document H21-A5:28(5).
4. Gottfried EL, Adachi MM. Prothrombin time and activated partial thromboplastin time can be performed on the first tube. Am J Clin Pathol. 1997; 107(6):681-683. 9169665
5. McGlasson DL, More L, Best HA, et al. Drawing specimens for coagulation testing: is a second tube necessary? Clin Lab Sci. 1999; 12(3):137-139. 10539100
6. Adcock DM, Bethel MA, Macy PA. Coagulation Handbook. Aurora, Colo: Esoterix−Colorado Coagulation; 2006.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
164525 Protein S-Functional 27822-6 164526 Protein S-Functional % 27822-6

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