Platelet Aggregation Study with Dense Granule (ATP) Release (New Orleans Lab)

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Justification

Comprehensive platelet aggregation studies should be included as part of initial bleeding workups to detect defects in platelet function. Platelets promote hemostasis by four interconnected mechanisms: 1) Adhering to sites of vascular injury or artificial surfaces, 2) Releasing compounds from their granules, 3) Aggregating together to form a hemostatic platelet plug and 4) Providing a procoagulant surface for activated coagulation protein complexes on their phospholipid membranes [2]. Since the activation of platelets is a multiphasic reaction involving different membrane bound receptors and intracellular signaling pathways, using multiple agonists at different concentrations is necessary to adequately assess platelet function and characterize abnormalities. This test can detect platelet function abnormalities associated with Glanzmann thrombasthenia, Bernard Soulier, von Willebrand Disease, ADP receptor defects, dense granule deficiency, and use of antiplatelet medications such as aspirin or Plavix.

STAT: < 24 hours (M-F)

LTA, Luciferase Assay

Draw Tube: Blue Top

Sample Type: Citrated Whole Blood

Specimen Requirements

	Sample Type	Volume Required	Minimum Volume	Stability
PREFERRED	Citrated Whole Blood	Eight tubes, 3mL each (or equivalent volume)	For pediatric minimum, please call (800) 566-3462.	Room Temperature: 4 hours By appointment only - must arrive at lab within 2 hours of draw
ALTERNATIVE	-	-	-	-

REJECTION CRITERIA	Samples received more than 2 hours after draw
SPECIAL INSTRUCTIONS	See Draw Guide By appointment only

General Information

METHODOLOGY	LTA, Luciferase Assay
STAT TAT	< 24 hours (M-F)
STAT TAT Performance	> 90% of results released in 24 hours
ROUTINE TAT	< 24 hours (M-F)
ALTERNATIVE NAMES	Platelet Function Assay, PFA
DESCRIPTION	Platelet aggregation is measured in response to a panel of 7 different platelet agonists at multiple concentrations for a total of 14 determinations. Each agonist is tested individually against platelets suspended in platelet rich plasma (PRP) and platelet response measured by light transmittance aggregometry (LTA), the gold standard methodology for platelet functional testing. ATP release can also be measured. The agonists and concentrations included in this panel have been selected from those recommended by platelet aggregation testing guidelines published by the College of American Pathologists (CAP), Clinical and Laboratory Standards Institute (CLSI), North American Specialized Coagulation Laboratory Association (NASCOLA) and the British Society of Haematology.
LIMITATIONS	-
NORMAL RANGE	Interpretation: Normal
ASSOCIATED TESTING	-
REFERENCES	-
SAMPLE REPORT	Upon request
NEW YORK STATE APPROVED	-

Test Codes

ORDER CODE	P1209
CPT CODE	85576x20
LOINC CODE	53568-2, 79188-9, 78522-0, 78527-9, 5995-6, 13592-1, 33550-5, 79130-1, 5998-0, 5996-4, 13592-1, 21027-8