Note:    1. This test is used for assessing CYP2C9 and VKORC1

                       genes for polymorphisms affecting the metabolism of

                       warfarin/Coumadin. If requesting for the use of drugs

                       other than warfarin, please order #83652 "Cytochrome

                       P450 2C9 Genotype" which only includes testing for the

                       CYP2C9 gene.

2.   Multiple drug metabolism genotype tests can be performed

                       on a single specimen after a single extraction. See "Multiple

                       Drug Metabolism Genotype Tests" in Special Instructions for

                       a list of tests that can be ordered together.

Submit only 1 of the following specimens:

Blood

Draw blood in a lavender-top (EDTA) tube(s), and send 3 mL of

EDTA whole blood refrigerated in original VACUTAINER(S).

Note:    1.  Bone marrow and liver transplants will interfere with testing.

                       For bone marrow transplant patients, buccal cells should be

                       provided from the recipient to obtain an accurate genotype.

                       For liver transplant patients, donor blood or buccal cells

                       should beprovided to obtain an accurate genotype for the

                       recipient patient  

2.   Transfusions will interfere with testing for up to 4 to 6 weeks.   

     DNA obtained from white cells may not provide useful

     information for patients who received a recent transfusion

     of blood that was not leukocyte-reduced. Wait 4 to 6 weeks

     until transfused cells have left the patient's circulation before

     drawing the patient's blood specimen for genotype testing.

                  3.  An "Informed Consent Form for DNA Testing" (Supply T576)

                       is available. See Special Instructions for a copy of the form.       

4.   Cytochrome P450 Patient Education Brochure (Supply T526)

     is available upon request.

Buccal Swab

Buccal Smear Collection Kit (Supply T543) is available. Collect specimen

as follows:

1.  Patient should rinse out mouth vigorously with mouthwash for approximately

     15 seconds.

2.  Remove Cyto-Pak Brush from container only touching "stick" end. Save

     container.

3.  Using medium pressure, rotate brush several times on inside of cheek.

4.  Place brush back into container, recap, and seal with parafilm.

5.  Repeat steps 2 through 4 on other cheek using second brush.

6.  Label each container with patient's name and accession number or

     hospital/clinic number.

7.  Please provide appropriate clinical information about patient as per

     specific test requirements.

Notes:   1. It is important that cells do not dry out during shipping.

                      Please ensure that container is tightly sealed with  

                      parafilm provided.

             2. It is also important that patient's buccal cells are not

                  contaminated with cells from any other source.  Do not

                  touch bristles. Do not brush too vigorously. If blood

                  appears, discard brush; and restart collection

                  process.

                  3.  An "Informed Consent Form for DNA Testing" (Supply T576)

                       is available. See Special Instructions for a copy of the form.

Refrig\Ambient OK\Frozen OK-Blood
Ambient\Refrig NO\Frozen NO-Buccal Swab

Specimens Other Than:                 Whole blood     

Anticoagulants Other Than:           EDTA, ACD

Hemolysis:                                          Lab will attempt testing

Thawing:                                              No. If received frozen, keep frozen

                                                                for delivery to Extraction Lab (ETV 14)

Lipemia:                                               No, Lab will attempt testing

Monday through Friday; varies