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Dilute Russell Viper Venom Test (dRVVT)

DRVVT, dRVVT (Dilute Russell Viper Venom Test), Russell Viper Venom Test, Dilute (dRVVT)

Test Codes

Antrim #26115, EPIC: LAB5177, DRVVT

Department

Coagulation

Instructions

• Specimens with hematocrit values greater than 55% must have anticoagulant adjusted. Specimens must be re-collected using a specified whole blood to sodium citrate ratio. Contact the performing Laboratory for specific instructions.

• Before dRVVT testing:
  o Patients should be off Coumadin for at least two weeks
  o Patients should be off apixaban/rivaroxaban at least two days*
  o Patients should be off dabigatran for at least four days*

        *assumes normal renal function 

Specimen Collection Criteria

Collect: One Light Blue-top 3.2% Sodium Citrate tube.

TUBE MUST BE FULL.

Physician Office/Draw Specimen Preparation

1. Centrifuge the capped tube at 1500 x g for 15 minutes.
2. Transfer plasma with a plastic pipette into a plastic polypropylene centrifuge tube, cap and centrifuge an additional 15 minutes at 1500 x g to obtain platelet poor plasma (PPP) which has a platelet count less than 10 bil/L. Plasma with a platelet count of less than 10 bil/L is critical for accurate results.
3. Immediately remove only the top two-thirds of the PPP and transfer it into a plastic tube.
4. Freeze (-20°C/-4°F or below) the PPP immediately.
5. Transport frozen on DRY ICE. Specimen must remain frozen during transport.

Preparation for Courier Transport

Transport: Whole blood at room temperature (20-25°C or 68-77°F), or plasma obtained through the process listed above, frozen (-20°C/-4°F or below).

Rejection Criteria

• Glass tubes and 3.8% Sodium Citrate tubes.
• Specimens that are clotted or grossly hemolyzed.
• Inappropriate specimen volume.
• Thawed or partially thawed specimens.

In-Lab Processing

Whole blood specimens must be processed as follows upon receipt in the Laboratory:

1. Centrifuge the capped tube at 1500 x g for 15 minutes.
2. Transfer plasma with a plastic pipette into a plastic polypropylene centrifuge tube, cap and centrifuge an additional 15 minutes at 1500 x g to obtain platelet poor plasma (PPP) which has a platelet count less than 10 bil/L. Plasma with a platelet count of less than 10 bil/L is critical for accurate results.
3. Immediately remove only the top two-thirds of the PPP and transfer it into a plastic tube.

4. Test or freeze specimen according to lab protocol.

Storage

Specimen Stability for Testing:

Whole Blood
Room Temperature (20-26°C or 68-78.8°F): 4 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Platelet Poor Plasma (PPP)
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): 30 days

Specimen Storage in Department Prior to Disposal:

Frozen (-20°C/-4°F or below): 30 days

Laboratory

Royal Oak Coagulation Laboratory

Performed

Performed at least twice a week.
Results available within 72 hours.

Reference Range

Normal Values:

dRVVT Screen: Less than 42 seconds.

dRVVT Confirm: Less than 35 seconds.

Normalized Ratio: Less than 1.20 

Test Methodology

Change in Optical Absorbance (IL ACL TOP Series).

Interpretation

• A positive dRVVT may indicate the presence of a lupus anticoagulant.
• To exclude the presence of a Lupus Anticoagulant (i.e., lupus inhibitor), the ISTH recommends that at least two different lupus anticoagulant sensitive tests are normal.
• Corewell Health offers four tests to exclude lupus anticoagulants. These are the Inhibitor Screen, dilute Russell Viper Venom Time (dRVVT), Hexagonal Phase Phospholipid, and Platelet Neutralization Procedure (PNP). More than one test should be used in the diagnosis of a lupus anticoagulant.

Clinical Utility

The dilute Russell viper venom time (dRVVT) is a confirmatory test for the lupus anticoagulant (LA). Patients with LA may have a prolonged aPTT without a history of bleeding, or a history of thrombosis or miscarriage. Coumadin, Heparin, and other coagulation inhibitors may prolong the dRVVT.

CPT Codes

85613

Contacts

Last Updated

7/31/2023