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HelpTest Code F_11 Coagulation Factor XI Activity Assay, Plasma
Reporting Name
Coag Factor XI Assay, PUseful For
Diagnosing deficiency of coagulation factor XI
Investigating prolonged activated partial thromboplastin time
Method Name
Optical Clot-Based
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Plasma Na CitOrdering Guidance
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.
Necessary Information
If priority specimen, mark request form, give reason, and request a call-back.
Specimen Required
Specimen Type: Platelet-poor plasma
Patient Preparation: Patient must not be receiving Coumadin (warfarin) or heparin therapy.
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° C or ideally, at or below -40° C.
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.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma Na Cit | Frozen | 14 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Special Instructions
Reference Values
Adults: 55-150%
Normal, full-term newborn infants or healthy premature infants may have decreased levels (≥10%), which may not reach adult levels for 180 or more days postnatal.*
*See Pediatric Hemostasis References section in Coagulation Guidelines for Specimen Handling and Processing.
Day(s) Performed
Monday through Saturday
CPT Code Information
85270
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| F_11 | Coag Factor XI Assay, P | 3226-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| F_11 | Coag Factor XI Assay, P | 3226-8 |
Clinical Information
Factor XI is synthesized in the liver. Its biological half-life is 60 to 80 hours. Factor XI is a component of intrinsic coagulation pathway and, when activated, activates factor IX to IXa.
Factor XI deficiency may cause prolonged partial thromboplastin time. Deficiency is associated with mild bleeding diathesis, but there is poor correlation between activity level and clinical bleeding. A relatively high incidence of congenital deficiency occurs among individuals of Ashkenazi Jewish descent (hemophilia C).
Interpretation
Acquired deficiency is associated with liver disease and rarely inhibitors.
Patients who are homozygous: <20% activity
Patients who are heterozygous: 20% to 60% activity
Cautions
Decreased plasma levels of factor XI do not correlate well with bleeding risk.
Method Description
The factor XI assay is performed on the Instrumentation Laboratory ACL TOP using the activated partial thromboplastin time (aPTT) method and a factor-deficient substrate. Patient plasma is combined and incubated with a factor XI-deficient substrate (normal plasma depleted of factor XI by immunoadsorption) and an aPTT reagent. After a specified incubation time, calcium 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; Cielsa B. Defects of plasma clotting factors. In: Hematology in Practice. 3rd ed. FA Davis; 2019:chap 17)