Difference between revisions of "Liver Function, Abnormal"
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==Explanation of Condition== | ==Explanation of Condition== | ||
| − | Abnormality of | + | Abnormality of one or more of the standard enzyme tests used to assess liver function. These include: |
ALT (Alanine transaminase) | ALT (Alanine transaminase) | ||
| Line 19: | Line 19: | ||
GGT (Gamma-glutamyl transpeptidase) | GGT (Gamma-glutamyl transpeptidase) | ||
| + | For elevated bilirubin, please see [[High bilirubin]] | ||
==Guidance== | ==Guidance== | ||
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 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)
For elevated bilirubin, please see High bilirubin
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
