Liver Function Test

Aka: Liver Function Test, LFT

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II. Labs: Markers of liver function and Protein synthesis

  1. Serum Albumin
  2. Serum Bilirubin
  3. Prothrombin Time

III. Labs: Markers of hepatocellular disease

  1. Alanine Aminotransferase (ALT)
    1. Most specific for hepatocyte injury
  2. Aspartate Aminotransferase (AST)
    1. Less specific than ALT (present outside liver)
  3. AST to ALT ratio
    1. Most liver conditions (e.g. NASH): Ratio <1
    2. Alcoholism: Ratio >2
    3. Wilson's Disease >4
  4. Lactate Dehydrogenase (LDH)
    1. Least specific for hepatocyte injury
    2. Dramatically increased in ischemic hepatitis
    3. Increased with alk phos in liver metastases

IV. Labs: Markers of cholestasis

  1. Alkaline Phosphatase
  2. Gamma glutamyl transferase (GGT)
  3. Serum Bilirubin

V. Labs: Disease specific markers

  1. Definite value
    1. Viral Hepatitis Serology
    2. Iron studies
    3. Ceruloplasmin (Wilson's Disease)
  2. Limited value: Anti-Smooth Muscle Ab
    1. Antimitochondrial Antibody
    2. Alpha-1 Antitrypsin

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