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Liver function tests (LFTs or LFs), also referred to as a hepatic panel or liver panel, are groups of blood tests that provide information about the state of a patient's liver. [1] These tests include prothrombin time (PT/INR), activated partial thromboplastin time (aPTT), albumin , bilirubin (direct and indirect), and others.
The main liver cells are called hepatocytes; however, there are other cells that can be observed in a liver sample such as Kupffer cells (macrophages). [2] The liver is the biggest gland of the body. It has a wide variety of functions that range from the destruction of old blood cells to the control of the whole metabolism of macromolecules. [3]
A hepatocyte is a cell of the main parenchymal tissue of the liver. Hepatocytes make up 80% of the liver's mass. These cells are involved in: Protein synthesis; Protein storage; Transformation of carbohydrates; Synthesis of cholesterol, bile salts and phospholipids; Detoxification, modification, and excretion of exogenous and endogenous substances
The proportion of AST to ALT in hepatocytes is about 2.5:1, but because AST is removed from serum by the liver sinusoidal cells twice as quickly (serum half-life t 1/2 = 18 hr) compared to ALT (t 1/2 = 36 hr), so the resulting serum levels of AST and ALT are about equal in healthy individuals, resulting in a normal AST/ALT ratio around 1.
Muscle sources of the enzymes, such as intense exercise, are unrelated to liver function and can markedly increase AST and ALT. [5] Cirrhosis of the liver or fulminant liver failure secondary to hepatitis commonly reach values for both ALT and AST in the >1000 U/L range; however, many people with liver disease have normal transaminases.
A number of liver function tests are available to test the proper function of the liver. These test for the presence of enzymes in blood that are normally most abundant in liver tissue, metabolites or products. serum proteins, serum albumin, serum globulin, alanine transaminase, aspartate transaminase, prothrombin time, partial thromboplastin ...
This occurs via an increased extracellular matrix deposition around hepatocytes and sinusoidal cells which causes a peri-cellular fibrosis known as "chickenwire fibrosis". [7] This peri-cellular chickenwire fibrosis leads to portal hypertension or an elevated blood pressure in the portal veins that drain blood from the intestines to the liver. [7]
After several years, chronic infection may cause cirrhosis or liver cancer. [5] The liver enzymes measured from blood samples are normal in 7–53%. [21] (Elevated levels indicate the virus or other disease is damaging liver cells). Late relapses after apparent cure have been reported, but these can be difficult to distinguish from reinfection ...