Test ID: TT
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Thrombin Time
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Useful For
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The test measures the time (in second ) taken to convert fibrinogen to fibrin. Therefore the test is useful in the diagnosis of cases of Hypofibrinogenemia /dysfibrinogenemia ; hereditary or acquired such as advanced liver disease , cancers and DIC .Thrombin test is sensitive to heparin contamination.
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Method name and description
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Coagulometric (Turbidimetric).
Test is performed using sysmex CS 5100 analyzer. Thrombin converts the fibrinogen in the plasma sample into fibrin, thus producing a fibrin clot. The time taken for the fibrin clot to form is measured
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Clinical information
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Hyperfibrinogenemia as a cause of prolonged thrombin clotting time. Recognized causes of a prolonged thrombin clotting time (TT) include a decreased plasma fibrinogen level, dysfibrinogenemia, paraproteinemia, heparin contamination, elevated levels of fibrin degradation products, and liver failure.
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Specimen type / Specimen volume / Specimen container
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Plasma Na Cit. Platelet-poor plasma.
Specimen Volume: 2.7 ml.
Container/Tube: Light-blue top (citrate).
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Collection instructions / Special Precautions / Timing of collection
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Sample collected in HMC facilities/others and transported to the lab within 1hour :
• Collect sample into light blue-top (sodium citrate).
• Tubes must be filled to within +/- 10% of their proper volume, to provide a 9:1 ratio of blood to citrate.
2- Samples collected in HMC facilities / others and which are expected not to reach the lab within 1hour:
• Centrifuge the whole blood and carefully remove the plasma by pipette not by decanting and send the plasma in a temperature-controlled environment (18-25ºC ) within one hour of centrifugation.
• If the transportation of the plasma can’t be within a maximum of 2hour , prepare platelet-poor plasma as follow:
A: Re-centrifuge plasma again.
B: Remove the top portion of plasma leaving approximately 250 mcL in the bottom to discard.
C: The double-centrifuged plasma should be aliquoted (0.5 to 1 mL per aliquot) into labeled plastic tubes. The number of tests ordered will determine the aliquots needed.
D: Freeze immediately at -20 ºC or below .
E: Specimens must arrive frozen.
3- Sample for Platelets function studies (Platelets function assay) , Citrated whole blood should reach HMC within a maximum of 1-2 hours of collection.
4- For heparin monitoring, follow the above mentioned steps.
5- Consider patient HCT %. , if HCT is >55%, the volume of anticoagulant in the tube must be adjusted by the referring lab, as per the below table shows the volume of citrate (µL) to be removed from common sizes of coagulation specimen tubes prior to specimen collection. After removal of the specified volume of citrate, enough blood is added to fill the tube to the ideal volume. .
Hematocrit % |
Volume to be removed, µL |
2.7 ml Tube |
1.0 ml Tube |
56 |
50 |
20 |
57 |
50 |
20 |
58 |
60 |
20 |
59 |
60 |
20 |
60 |
70 |
30 |
61 |
70 |
30 |
62 |
80 |
30 |
63 |
80 |
30 |
64 |
90 |
30 |
65 |
90 |
30 |
66 |
100 |
40 |
67 |
100 |
40 |
68 |
110 |
40 |
69 |
110 |
40 |
70 |
120 |
40 |
71 |
120 |
40 |
72 |
130 |
50 |
73 |
130 |
50 |
74 |
140 |
50 |
75 |
140 |
50 |
76 |
150 |
50 |
77 |
150 |
60 |
78 |
160 |
60 |
79 |
160 |
60 |
80 |
170 |
60 |
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Relevant clinical information to be provided
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Patient/family history of bleeding disorder. History of anticoagulant therapy.History of chronic diseases.
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Storage and transport instructions
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Specimen Rejection Criteria
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Specimens with no label or missing required identification
Broken, leaking or contaminated specimen
Clotted samples
Under-filled or overfilled sample tubes.
Wrong sample container sample received
Improper specimen transport temperature (e.g. like specimens which are needed to be sent on ice)
Old specimen (test-dependent)
Grossly Hemolyzed sample (test-dependent)
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Biological reference intervals and clinical decision values
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For age > 18 years: 16.5 - 20.7 second.
For age ≤18 years: The reference range is quoted from literature. The reference range values have not been verified/established by Lab.
Age |
Reference interval(sec) |
0 Minutes-4 Days |
19-28.3 |
4 Days-1 Months |
18-29.2 |
1 Months-6 Months |
16.2-24.9 |
6 Months-1 Years |
15.4-21.1 |
1 Years-5 Years |
15.3-19.7 |
5 Years-10 Years |
14.5-19.9 |
10 Years-18 Years |
15.2-24 |
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Factors affecting test performance and result interpretation
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No interference up to:
Triglycerides 203 mg/dL
Hemoglobin 200 mg/dL
Bilirubin 60 mg/dl
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Turnaround time / Days and times test performed / Specimen retention time
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STAT: 1hr.
Routine: 4 hrs / Daily / NA.
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