Liver Blood Tests

A series of special blood tests can often determine whether or not the liver is functioning properly. These tests can also distinguish between acute and chronic liver disorders and between hepatitis and cholestasis. The most commonly performed blood tests include:

Serum Bilirubin Test

Elevated levels of bilirubin often indicate an obstruction of bile flow or a defect in the processing of bile by the liver. Bilirubin is produced by the liver and is excreted in the bile.

Serum Albumin Test

Below-normal levels of albumin, a protein made by the liver, are associated with many chronic liver disorders.

Serum Alkaline Phosphatase Test

Elevated levels of alkaline phosphatase, an enzyme found in the bile, usually indicate an obstruction of bile flow, liver injury, or certain cancers.

Alanine Transaminase (ALT) Test

This enzyme is released from damaged liver cells.

Aspartate Transaminase (AST) Test

This enzyme is released from damaged liver, heart, muscle, or brain cells.

Gamma-glutamyl Transpeptidase (GGT) Test

This enzyme is produced by the liver, pancreas, and kidneys and released into the blood when these organs are injured. It is particularly sensitive to alcohol related liver damage.

Lactic Dehydrogenase Test

This enzyme is released when organs such as the liver, heart, lung, or brain are injured.

5-Nucleotidase Test

This enzyme is released by the liver when the liver is injured due to bile duct obstruction or impaired bile flow.

Prothrombin Time (PTT) Test

This test measures the time it takes for blood to clot. Blood clotting requires vitamin K and a protein made by the liver. Liver cell damage and bile flow obstruction can both interfere with proper blood clotting.

Not all of these tests are useful for all patients. The attending physican will usually decide on which tests are required and how useful the results obtained are before a diagnosis can be made. Often, other tests are required to gauge other elements of liver structure and function. These are discussed below.

Common Liver Tests

Specific liver blood tests can be performed in order to assess liver function. However, often a more detailed assessment is required to assess the size, shape and nature of liver tissue and the surrounding organs. This can be done by using various scans and other investigations to directly or indirectly visualise the area in question. Examples of these tests are given below.

Abdominal X-rays

Plain radiographs (X-rays) which show many aspects of organs within the abdominal cavity.

Ultrasound Scans

These are used to visualise organs to show their size, shape and texture and to show the presence of masses and other structural abnormalities.

Nuclear or Radioisotope Scans

Radioactive markers or dyes are used to show changes in the liver structure and function.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

A thin tube called an endoscope is used to view various structures in and around the liver.

CT scan/MRI scan

Various types of 2 dimensional or 3 dimensional images can be obtain which show liver structure in great detail.

Some liver diseases can be diagnosed only by a liver biopsy.

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