Difference between revisions of "Liver Function, Abnormal"
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==Guidance== | ==Guidance== | ||
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| − | LFTs greater than twice upper limit of normal but less than thrice upper limit of normal | + | <b> If LFTs are less than twice the upper limit of normal: </b> |
| + | |||
| + | The donor can be cleared. | ||
| + | For donor health, a repeat value should be checked. This can be done by either checking LFTs on day of donation (DOD), or by asking the donor's GP to re-check their LFTs once the donation is complete. If LFTs are checked on DOD and remain abnormal, GP follow-up should be arranged. | ||
| + | |||
| + | |||
| + | <b> If LFTs are greater than twice the upper limit of normal but less than thrice upper limit of normal: </b> | ||
| + | |||
| + | Review the following tests from the medical assessment: | ||
| + | |||
| + | * Infectious disease marker results (HIV, Hepatitis, EBV, CMV etc). Abnormal virology results should be followed up as appropriate (see the relevant pages). | ||
| + | * 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: | ||
| + | |||
| + | * Liver USS. | ||
| + | * A standard liver profile: AST, ALP, GGT. | ||
| + | * Autoantibodies (anti-mitochondrial Abs, anti-smooth muscle Abs and ANAs). | ||
| + | * Immunoglobulins. | ||
| + | * 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. | ||
| + | |||
| + | 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. | ||
| + | |||
| + | |||
| + | <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. | ||
==Pseudonyms or Related Conditions== | ==Pseudonyms or Related Conditions== | ||
Revision as of 12:49, 4 June 2024
Contents
Acceptability at Recruitment
QUALIFIED
Acceptability at CT / Work-Up
QUALIFIED
Individual at Risk
Donor, Recipient
Explanation of Condition
Abnormality of bilirubin and/or one or more of the standard enzyme tests used to assess liver function. These include:
ALT (Alanine transaminase)
AST (Aspartate transaminase)
ALP (Alkaline phosphatase)
GGT (Gamma-glutamyl transpeptidase)
Guidance
If LFTs are less than twice the upper limit of normal:
The donor can be cleared. For donor health, a repeat value should be checked. This can be done by either checking LFTs on day of donation (DOD), or by asking the donor's GP to re-check their LFTs once the donation is complete. If LFTs are checked on DOD and remain abnormal, GP follow-up should be arranged.
If LFTs are greater than twice the upper limit of normal but less than thrice upper limit of normal:
Review the following tests from the medical assessment:
- Infectious disease marker results (HIV, Hepatitis, EBV, CMV etc). Abnormal virology results should be followed up as appropriate (see the relevant pages).
- 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:
- Liver USS.
- A standard liver profile: AST, ALP, GGT.
- Autoantibodies (anti-mitochondrial Abs, anti-smooth muscle Abs and ANAs).
- Immunoglobulins.
- 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.
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 liver function tests are greater than thrice the upper limit of normal:
Arrange repeat LFTs. If the repeat result is the same, the donor cannot be cleared.
Pseudonyms or Related Conditions
LFT
LFTs
Version
Version 1, Edition 1
Date of Last Update
16th October 2012
