Disease Diagnosis (Liver function tests, Liver ultrasound, Liver biopsy)

Liver Function Tests

Liver function tests (LFTs) are basic tests that consist of a series of tests on a sample of blood done.

Liver function tests are performed in your GP surgery, in a hospital and in many other areas where you may be being investigated for liver disease. As no test is completely accurate, it is good practice to do a number or series of tests over time to allow the doctor, nurse or specialist to examine a trend in your results, especially if the tests detect anything abnormal.

The Liver function test takes a look at different properties of your blood. The most common parts to the test you may have are:

  • Alanine Aminotransferase (ALT)
    • Provides an indication of the degree of inflammation as well as the possible causes
  • Aspartarte Aminotransferase (AST)
    • Provides an indication of the degree of inflammation as well as the possible causes
  • Alkaline Phosphatase (ALP)
    • Indicative of obstructive liver disease
  • Gamma-Glutamyl Transferase (GGT or "Gamma GT")
    • Indicative of obstructive liver disease as well as alcohol usage
  • Bilirubin
    • Suggestive of liver disease, especially in disease of the bile ducts
  • Albumin
    • Suggestive of chronic liver disease
  • Clotting Studies (Prothrombin Time)
    • Suggestive of liver disease, especially worsening chronic liver disease if the prothrombin time is prolonged, as the liver is significantly involved in the normal clotting of blood


Liver Ultrasound

Apart from LFTs, you may also be required to undergo a liver biopsy, and if this is the case, you may be asked to go for an ultrasound first.

Your liver ultrasound will usually be performed in the X-ray department of the hospital or in an outpatient clinic, day care department or ward. Normally, the ultrasound of your liver is a procedure done by a radiologist.

The machine will record the images of your liver and a report will be made by the radiologist. The report will only show the surface and the shape of the liver but will not show a detailed view of any abnormalities that may exist in the liver.

As the ultrasound only gives a pictorial overview of the liver, a liver biopsy is invariably the next step to definitely diagnose the liver disease.


Liver Biopsy

On its own, LFTs cannot diagnose a condition based on symptoms and simple blood tests. Often the only way to diagnose a liver disease and identify how advanced it is to perform a liver biopsy.

Your liver biopsy is usually performed by a gastroenterologist, hepatologist or radiologist. Firstly, a blood sample will be taken to check your blood’s ability to clot. This is a routine precaution and is to ensure the liver biopsy can be performed safely with minimal risks. A local anaesthetic is administered prior to the liver biopsy procedure.

Your liver biopsy sample is sent to a pathologist who will examine it under a microscope and produce a report. The report will describe any inflammation or scarring (fibrosis) that may exist.