Liver Function Test :Normally this is used in Routine lab test .Prescribed by Consultant or General Physician.

1. Liver Function Test(LFT)
By: Shahid Nawaz

7. Functions
 The liver is a reddish brown wedge-
shaped organ with four lobes of unequal
size and shape.
 A human liver normally weighs
1.44–1.66 kg (3.2–3.7 lb).

8.  It’s important to remember that diagnosis of liver
disease depends on a combination of patient history,
physical examination, laboratory testing, biopsy and
sometimes imaging studies such as ultrasound scans.
What are liver function tests?

9.  Liver function tests are blood tests used to help
diagnose and monitor liver disease or damage.
 The tests measure the levels of certain enzymes
and proteins in our blood.
 Some of these tests measure how well the liver
is performing its normal functions of producing
protein and clearing bilirubin, a blood waste
product.
Definition

10.  The Role of the Liver is to keep the Body’s Complex Internal Chemistry
in balance.
 It takes Raw Nutrients From Our Digestive System
 In the form of carbohydrates, protein, amino acids
 Processes them so they can be stored and sent to different parts of
our body in the right form and quantity.
 Liver regulates the level of sugars in our blood and
manufactures bile (which breaks down fats in our stomach).
 It also helps to remove Toxins, Drugs and Hormones from our
Bloodstream.
 This brief explanation does the liver little justice - it actually carries out
over 1,500 complex biochemical functions.
Role of The Liver

11.  Liver function tests can be used to:
 Screen for liver infections, such as hepatitis
 Monitor the progression of a disease, such as viral or
alcoholic hepatitis, and determine how well a
treatment is working
 Measure the severity of a disease, particularly
scarring of the liver (cirrhosis)
 Monitor possible side effects of medications
Why it's done

12.  ALT is an enzyme made by cells in the liver.
 The liver is the body’s largest gland. It has
several important functions, including:
 making proteins
 storing vitamins and iron
 removing toxins from the blood
 producing bile, which aids in digestion
Alanine transaminase (ALT)

13.  ALT Is an enzyme produced in hepatocytes (the major type
of liver cells).
 ALT level in the blood is increased when hepatocytes are
damaged or die - all types of hepatitis (viral, alcoholic, drug
induced etc) cause hepatocyte damage.
 Levels of ALT may equate to the degree of cell damage
but this is not always the case, particularly with hepatitis C.
 An accurate estimate of liver cell damage can only be made
by liver biopsy.
Alanine transaminase (ALT)

14.  Relatively low concentrations in other tissues so more
specific than AST .
 Levels fluctuate during the day Rise may occur with
the use of certain drugs or during periods of
strenuous exercise.
Alanine Transaminase (ALT)

15.  The ALT test is usually used to determine
whether someone has liver injury or failure.
symptoms of liver disease, including:
 jaundice, which is yellowing of the eyes or skin
 dark urine
 nausea
 vomiting
 right upper quadrant abdominal pain
Alanine transaminase (ALT)

16.  Proteins called enzymes help the liver break
down proteins so the body can absorb them
more easily. ALT is one of these enzymes.
 It plays a crucial role in metabolism, the process
that turns food into energy.
 ALT is normally found inside liver cells.
 when the liver is damaged or inflamed, ALT can
be released into your bloodstream. This causes
serum ALT levels to rise.
 Normal Values : 7 to 55 (U/L)
Alanine transaminase (ALT)

17.  AST is an enzyme found in various parts of the
body.
 The highest concentrations are found in muscle,
heart, and liver.
 A small amount of AST is typically found in the
bloodstream.
 Elevated amounts of this enzyme may signal a
health problem.
Aspartate aminotransferase (AST)

18. Symptoms
weakness
loss of appetite
nausea or vomiting
swelling in the abdomen
yellow skin or eyes (jaundice)
dark urine
severe skin itching
Aspartate Transaminase (AST)

19.  AST Is similar to ALT , but less specific for liver disease
because it is also produced in body muscle cells. It
does tend to be higher than ALT in cases of alcohol-
related liver disease.
Aspartate Transaminase (AST)

20. • Occurs in two Isoenzyme, indistinguishable on standard
AST assays.
• The mitochondrial Isoenzyme is produced in hepatocytes
and reacts to membrane stresses in a similar way to ALT.
• The cytosolic Isoenzyme is present in skeletal muscle, heart
muscle and kidney tissue.
• Caution must be exercised in its use to evaluate
hepatocellular damage.
• Usually rises in conjunction with ALT to indicate
hepatocellular injury: a Hepatitic picture.
Aspartate Transaminase (AST)

21.  This test may also be ordered for people at high
risk of developing liver problems.
 exposure to viruses that cause hepatitis
 heavy alcohol use
 family history of liver disease
 diabetes
 being overweight
 Normal Values: 8 to 48 U/L
Aspartate Transaminase (AST)

22.  Alkaline phosphatase is an enzyme found in our
bloodstream.
 ALP helps break down proteins in the body and
exists in different forms, depending on where it
originates.
 It is mostly produced in our liver, but some is also
made in our bones, intestines, and kidneys.
Alkaline phosphatase (ALP).

23.  ALK Phosphatase Refers to Alkaline Phosphatase, a
family of enzymes produced in the bile ducts,
intestine, kidneys, placenta and bones. These levels
may rise when disease of the bile ducts or bone
disorders occur.
ALK Phosphatase

24. • A group of Isoenzyme that act to dephosphorylate a
variety of molecules throughout the body.
• Produced in the membranes of cells lining bile ducts and
canaliculi.
• Released in response to the accumulation of bile salts or
cholestasis.
• Non-hepatic production in the kidney, intestine,
leukocytes, placenta and bone.
• Physiological rise in pregnancy or in growing children.
• Pathological rise in Paget’s disease, renal disease and with
bone metastases.
ALK Phosphatase

25.  Higher levels of ALP may indicate liver damage
or disease, such as a blocked bile duct, or certain
bone diseases.
 Abnormal levels of ALP also indicate
malnutrition, kidney tumors, or a serious
infection.
 The normal range of ALP varies from person to
person and depends on your age, blood type,
gender.
 Normal Values: 45 to 115 U/L
ALK Phosphatase

26.  Proteins are important building blocks of all cells
and tissues.
 Proteins are necessary for our body’s growth,
development, and health.
 Total Protein contains albumin and globulin.
Albumin proteins keep fluid from leaking out of
your blood vessels.
Globulin proteins play an important role in our
immune system.
Total Protein

27. Low total protein may indicate:
 bleeding
 liver disorder
 kidney disorder, such as a nephrotic disorder or
glomerulonephritis
 malnutrition
 extensive burns
 inflammatory conditions
 delayed post-surgery recovery
Total Protein

28.  Elevated total protein may indicate:
 inflammation or infections, such as viral hepatitis
B or C, or HIV
 bone marrow disorders, such as multiple
myeloma disease
 Normal Values
Total Protein: 6.3 to 7.9 g/dL
Total Protein

29.  Albumin Provides a gauge of nutritional status. Can
be reduced due to liver damage and kidney disease.
Because albumin is made in the liver, levels tend to
drop with cirrhosis.
Albumin

30.  Globulin Describes the specific level of globulins -
which include antibodies.
 This measure can be raised when liver cells are
damaged due to autoimmune liver damage or to long-
standing liver disease of many types, particularly
when cirrhosis exists.
Globulin

31.  Bilirubin is a substance produced during the
normal breakdown of red blood cells.
 Bilirubin passes through the liver and is excreted
in stool.
 Elevated levels of bilirubin (jaundice) might
indicate liver damage or disease or certain types
of anemia.
Bilirubin

32.  In an adult, high bilirubin may be due to
problems with the liver, bile ducts, or
gallbladder. Examples include:
 drug toxicity
 liver diseases like hepatitis
 cirrhosis (scarring of the liver)
 cancer of the gallbladder or pancreas
 Gallstones
 Normal Values : 0.1 to 1.2 mg/dL
Bilirubin

33.  GGT test measures the amount of the enzyme
GGT in our blood.
 Enzymes are molecules that are necessary for
chemical reactions in our body.
 GGT functions in the body as a transport
molecule, helping to move other molecules
around the body.
 It plays a significant role in helping the liver
metabolize drugs and other toxins.
gamma-Glutamyl transpeptidase (GGT)

34.  GGT is concentrated in the liver.
 it’s also present in the gallbladder, spleen,
pancreas, and kidneys.
 GGT blood levels are usually high when the liver
is damaged.
gamma-Glutamyl transpeptidase (GGT)

35. The symptoms of liver problems include:
 decreased appetite
 vomiting or nausea
 lack of energy
 abdominal pain
 jaundice, which is a yellowing of the skin
 unusually dark urine
 light-colored feces
 itchy skin
 Normal Values : 9 to 48 U/L
gamma-Glutamyl transpeptidase (GGT)

36. Normal Values & Changes

38. Thank You