Liver Function, Abnormal - Revision history

Maram.Ghiti@anthonynolan.org: /* 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

2024-06-04T12:51:04Z

Explanation of Condition

2024-06-04T12:49:58Z

Explanation of Condition

2024-06-04T12:49:18Z

Guidance

@@ 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.

@@ Line 40: / Line 40: @@
 * 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.
@@ Line 49: / Line 49: @@
 * 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.

@@ Line 48: / Line 48: @@
 * HbA1c.
 * 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.

@@ Line 39: / Line 39: @@
 * Ferritin.
 * 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:

@@ Line 19: / Line 19: @@
 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
Line 61:		Line 61:

	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==

@@ Line 69: / Line 69: @@
 ==Version==
-Version 1, Edition 1
+Version 1, Edition 2
 ====Date of Last Update====
-th October 2012
+th June 2024

← Older revision		Revision as of 12:51, 4 June 2024
Line 18:		Line 18:

	GGT (Gamma-glutamyl transpeptidase)		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).

	For elevated bilirubin, please see [[High bilirubin]]		For elevated bilirubin, please see [[High bilirubin]]

@@ Line 9: / Line 9: @@
 ==Explanation of Condition==
-Abnormality of bilirubin and/or one or more of the standard enzyme tests used to assess liver function. These include:
+Abnormality of one or more of the standard enzyme tests used to assess liver function. These include:
 ALT (Alanine transaminase)
@@ Line 19: / Line 19: @@
 GGT (Gamma-glutamyl transpeptidase)
 ==Guidance==

@@ Line 21: / Line 21: @@
 ==Guidance==
-LFTs greater than twice upper limit of normal but less than thrice upper limit of normal discovered at pre-harvest medical: arrange urgent liver ultrasound. Accept if normal or fatty liver, and standard hepatitis screen is negative. Inform transplant centre.
+<b> If LFTs are less than twice the upper limit of normal: </b>
 ==Pseudonyms or Related Conditions==