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▪ •Many of the clotting factors that help your blood to clot normally.
▪ •Plays a part in red blood cell production.
▪ •Albumin, the main protein in your blood, which bulks out your serum and enables it to
carry essential substances around the body.
▪ • Angiotensinogen, which plays a role in blood pressure control.
ROLE OF THE LIVER :
▪ The role of the liver is to keep the body’s complex internal chemistry in
balance. It takes raw nutrients from our digestive system (in the form of
carbohydrates, protein, amino acids, etc.) and processes them so they can
be stored and sent to different parts of our body in the right form and
quantity.
▪ The liver regulates the level of sugars in our blood and manufactures bile
(which breaks down fats in our stomach). It also helps remove toxins, drugs
and hormones from our bloodstream.
WHAT ARE LIVER FUNCTION TESTS :
▪ Liver function tests (also known as a liver panel) are blood tests that measure
different enzymes, proteins, and other substances made by the liver and monitor liver
disease or damage. An initial step in detecting liver damage is a simple blood test to
determine the level of certain liver enzymes (proteins) in the blood.
WHAT ARE LIVER FUNCTION TESTS :
▪ A liver function test (LFT) is a blood test that gives an indication of whether the liver is
functioning properly. The test is also very useful to see if there is active damage in the liver
(hepatitis) or sluggish bile flow (cholestasis).
▪ Liver function tests measure the amount of particular chemicals in the blood. This gives a
gauge of possible damage to liver cells - damage that can be caused by many things
including HCV. So a more correct term for a liver test would actually be a liver dysfunction
test
▪ Your liver does all kinds of work that’s crucial for your health. It helps break down food,
clean your blood, make proteins, and store energy.
WHY PERFORM LFT :
▪ A variety of diseases and infections can cause acute or chronic damage to the liver,
causing inflammation, scarring, bile duct obstructions, clotting abnormalities, and liver
dysfunction. Alcohol, drugs, some herbal supplements, and toxins can also pose a
threat.
▪ •to check for damage from liver infections, such as hepatitis B and hepatitis C
▪ •to monitor the side effects of certain medications known to affect the liver
▪ •Monitor treatment of liver disease. These tests can show how well the treatment is
working
▪ •Measure the severity of a disease, particularly scarring of the liver (cirrhosis)
WHY PERFORM LFT:
▪ •if you already have a liver disease, to monitor the disease and how well a
particular treatment is working
▪ •if you’re experiencing the symptoms of a liver disorder
▪ •Monitor side effects of certain medicines
▪ •if you have certain medical conditions such as high triglycerides, diabetes, high
blood pressure, or anaemia
▪ •if you drink alcohol heavily
▪ •if you have gallbladder disease
LIVER DISEASE SYMPTOMS :
▪ The liver has multiple functions. It makes many of the chemicals required by the body
to function normally, it breaks down and detoxifies substances in the body, and it
also acts as a storage unit. When the liver is damaged from disease, medication,
alcohol, or other factors., a person may have symptoms of liver disease such as:
▪ •Nausea and vomiting
▪ •jaundice (yellowing of the skin)
▪ •fatigue
▪ •weakness
LIVER DISEASE SYMPTOMS :
▪ •dark urine
▪ •shortness of breath
▪ •excessive bruising or bleeding
▪ •leg swelling
▪ • pruritus
▪ •diarrhoea
▪ •unexplained weight loss
STAGES OF LIVER DISEASE
SUBSTANCES MEASURED IN LIVER FUNCTION
TESTING :
ASPARTATE AMINOTRANSFERASE
(AST) :
▪ AST is a type of protein called an enzyme that is found in the liver as well as many
muscles and organs. Is an enzyme produced in hepatocytes (the major type of liver
cells).
▪ ALT level in the blood is Increased when hepatocytes are damaged or die - all types
of hepatitis (viral, alcoholic, drug induced etc.) cause hepatocyte damage. Levels of
ALT may equate to the degree of cell damage but this is not always the case,
particularly with hepatitis C.
▪ •AST level under 40 IU/L is considered normal.
ALANINE TRANSFERASE (ALT) :
▪ A family of enzymes produced in the bile ducts, intestine, kidneys, placenta and
bones comes mainly from the cells lining bile ducts and from bones - particularly
growing bones.
▪ It rises if there is slow or blocked flow in the bile ducts, if the bile ducts are
damaged and in bone disorders it rises when you have Gallstones. Hepatitis of
any cause, Cirrhosis, Bile duct blockage of any cause.
▪ •under 104 IU/L is considered normal for men
▪ •under 129 IU/L is considered normal for women
NORMAL VALUES OF LFT’S
GAMMA- GLUTAMYL TRANSFERASE (GGT) :
▪ GGT is an enzyme found in the liver and other organs. Is an enzyme produced in bile
ducts that may be elevated due to bile duct illness. The GGT test is extremely
sensitive and may be elevated due to any type of liver disease or by different drugs,
including alcohol, even when liver disease is minimal.
▪ GGT levels are sometimes elevated even in the case of a normally functioning liver.
GGT rises to 2-3 times the upper limit of normal in non-alcoholic fatty liver disease
(NAFLD). This condition is increasingly common and can progress to scarring or
inflammation of the liver. Transaminase levels also tend to rise in NAFLD.
▪ •under 60 IU/L is considered normal for men
▪ •under 42 IU/L is considered normal for women
How is the sample collected for testing :
▪ A blood
sample is
obtained by
inserting a
needle into a
vein in the
arm.
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