Liver Function, Abnormal - Revision history

Frances.Sarkari@anthonynolan.org: /* Guidance */

2026-08-13T13:27:57Z

Guidance

2026-08-13T13:27:35Z

Guidance

2026-08-13T13:27:06Z

Guidance

2024-06-05T13:38:32Z

Guidance

2024-06-05T13:36:18Z

Guidance

2024-06-05T13:33:50Z

Guidance

2024-06-05T13:33:39Z

Guidance

2024-06-05T13:31:50Z

Explanation of Condition

2024-06-04T12:52:11Z

Guidance

2024-06-04T12:51:35Z

Version

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 * Liver USS.
-* A standard liver profile: AST, ALP, GGT.
+* A standard liver profile: ALT, AST, ALP, GGT.
 * Autoantibodies (anti-mitochondrial Abs, anti-smooth muscle Abs and ANAs).
 * Immunoglobulins.

@@ Line 43: / Line 43: @@
 * Liver USS.
-* A standard liver profile: ALT, AST, ALP, GGT.
+* A standard liver profile: AST, ALP, GGT.
 * Autoantibodies (anti-mitochondrial Abs, anti-smooth muscle Abs and ANAs).
 * Immunoglobulins.

@@ Line 43: / Line 43: @@
 * Liver USS.
-* A standard liver profile: AST, ALP, GGT.
+* A standard liver profile: ALT, AST, ALP, GGT.
 * Autoantibodies (anti-mitochondrial Abs, anti-smooth muscle Abs and ANAs).
 * Immunoglobulins.

@@ Line 52: / Line 52: @@
 If any other abnormalities suggestive of more advanced NAFLD such as steatosis are identified on ultrasound, a fibroscan should be arranged.
-If a fibroscan demonstrates NASH or cirrhosis, the donor cannot be cleared.
+If a fibroscan demonstrates NASH or cirrhosis, the donor cannot be cleared. The donor should be referred to Hepatology via their GP.
 <b> If liver function tests are greater than thrice the upper limit of normal: </b>
-Arrange repeat LFTs. If the repeat result is the same, the donor cannot be cleared.
+Arrange repeat LFTs. If the repeat result is the same, the donor cannot be cleared. The donor should be referred to Hepatology via their GP.

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 * Markers of hepatic synthetic function (albumin, coagulation screen, platelets, bilirubin). If blood tests suggest hepatic dysfunction, discuss this with an SMO/donor consultant.
-Arrange the following tests:
+Arrange the following additional tests:
 * Liver USS.
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 * Transferrin saturation (if abnormal ferritin).
-If fatty liver is identified on ultrasound and all other tests are normal, the donor can be cleared. A letter should be written to their GP to repeat liver enzymes in 3 months’ time and continue follow up.
+If fatty liver is identified on ultrasound and all other tests are normal, the donor can be cleared. Lifestyle advice should be discussed, and a letter should be written to their GP to repeat liver enzymes in 3 months’ time.
 If any other abnormalities suggestive of more advanced NAFLD such as steatosis are identified on ultrasound, a fibroscan should be arranged.
 If a fibroscan demonstrates NASH or cirrhosis, the donor cannot be cleared.

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 GGT (Gamma-glutamyl transpeptidase)
-Acceptability for donation depends on the degree of elevation of LFTs. There are many causes for elevated LFTs, but in the UK the most common cause is non-alcoholic fatty liver disease (NAFLD).
+Acceptability for donation depends on the degree of elevation of LFTs and the underlying cause. There are many causes for elevated LFTs, but in the UK the most common cause is non-alcoholic fatty liver disease (NAFLD).
 For elevated bilirubin, please see [[High bilirubin]]

← Older revision		Revision as of 12:52, 4 June 2024
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	Arrange repeat LFTs. If the repeat result is the same, the donor cannot be cleared.		Arrange repeat LFTs. If the repeat result is the same, the donor cannot be cleared.
		+
		+
		+	For elevated bilirubin levels, please see [[High bilirubin]]

	==Pseudonyms or Related Conditions==		==Pseudonyms or Related Conditions==

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 ==Version==
-Version 1, Edition 1
+Version 1, Edition 2
 ====Date of Last Update====
-th October 2012
+th June 2024