Lab Guide
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Test ID: Factor II, Factor V, Factor VII and Factor X
Factor II assay, Factor Vassay, Factor VII assay and Factor X assay.
Useful For

To diagnose congenital deficiency of coagulation factor II, factor V factor VII, factor X and to evaluate acquired deficiencies associated with various clinical conditions such as liver disease, oral anticoagulant therapy and vitamin K deficiency and for monitoring therapy with administration of prothrombin concentrate2,

Method name and description

Turbidimetric
Test is performed using Sysmex CS5100 analyzer. Plasma deficient in any of the factors comprising the extrinsic and common pathways will result in a prolonged prothrombin time (PT). Coagulation factor deficient plasma can be used to confirm a factor deficiency in general, and to identify and quantify coagulation factor deficiency in patient plasma. A mixture of the factor deficient plasma and the patient plasma is tested in the PT assay and the result is interpreted using reference curve obtained with dilutions of Standard Human Plasma or normal pooled plasma mixed with deficient plasma. Patient plasma deficient in a specific factor will not be able to overcome the absence of the factor in the corresponding coagulation factor deficient plasma and therefore result in a prolonged PT.

Reporting name

Factor II
Factor X.
Factor V.
Factor VII.

Clinical information

Factor II, Factor V Factor VII and Factor X are a vitamin K-dependent serine protease synthesized in the liver. It is a component of the extrinsic coagulation scheme, measured by the prothrombin time.  Deficiency may result in a bleeding tendency.

Specimen type / Specimen volume / Specimen container

Plasma Na Cit. Plasma poor platelets.
Specimen Volume:  2.7 ml.
Container/Tube: Light-blue top (citrate)

Collection instructions / Special Precautions / Timing of collection

1- 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 >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
Relevant clinical information to be provided

Patient/family history of bleeding  disorder. History of anticoagulant therapy.History of chronic diseases

Storage and transport instructions

Ambient

Specimen Rejection Criteria

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)                                          

Biological reference intervals and clinical decision values

Reference range:  for age > 18 years:  

Factor Reference Range
FII (70 -120 %)
FV (70 - 120 %)
FVII (70 - 120 %)
FX (70 - 120 %)

for age ≤18 years:

*Reference Interval: Factor levels are expressed as percent of blood plasma concentration.
By definition, pooled plasma contains 100%(1unit/ml) of each factor.
*The reference range is quoted from literature.
The reference range values have not been verified /established by lab.

Factor

0 Minutes-4 Days

4 Days-1 Months

1 Months-6 Months

6 Months-1 Years

1 Years-5 Years

5 Years-10 Years

10 Years-18 Years

FVII

28-104

35-143

38-129

41-148

61-111

61-127

55-115

FX

12-268

19-79

55-120

67-146

75-124

69-118

66-117

FII

26-70

33-93

60-109

77-134

81-126

77-116

70-120

FV

34-108

45-145

56-148

66-141

68-143

62-127

55-119

Factors affecting test performance and result interpretation

No interference up to:
Triglycerides 600 mg/dL.
Hemoglobin 1000 mg/dL.
Bilirubin 60 mg/dL.

Turnaround time / Days and times test performed / Specimen retention time

For routine ordered test : 3 working days

For stat ordered test :

  • During the Laboratory working hours from 0700 hours to 1500 hours (Sunday to Thursday): TAT is Within 8hrs.
  • After duty hours, weekends and on holidays: TAT is within  12 hrs. with the following requirements:
  • Laboratory should  be notified by telephone about the sending  of a STAT sample.
  • The sample should  be hand-delivered to the central processing area and requesting  them to deliver it immediately to the hematology coagulation lab.

 Test is done : Daily.

Specimen retention time: NA