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8 - Laboratory Assessment of Liver Function and Injury in Children

from SECTION I - PATHOPHYSIOLOGY OF PEDIATRIC LIVER DISEASE

Published online by Cambridge University Press:  18 December 2009

By
Vicky Lee Ng M.D., F.R.C.P.C.
Edited by
Frederick J. Suchy ,
Ronald J. Sokol  and
William F. Balistreri
Vicky Lee Ng M.D., F.R.C.P.C.
Affiliation:
Assistant Professor, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; Medical Director, Liver Transplant Program, Staff Physician, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada
Frederick J. Suchy
Affiliation:
Mount Sinai School of Medicine, New York
Ronald J. Sokol
Affiliation:
University of Colorado, Denver
William F. Balistreri
Affiliation:
University of Cincinnati
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Summary

The liver is a multifunctional organ that is involved in a number of critical excretory, synthetic, and metabolic functions. Biochemical assessment of these functions in children is undertaken by utilizing a number of tests performed in clinical laboratories. Many of the most commonly used serum chemistry tests, such as aminotransferase and alkaline phosphatase levels, are often referred to as liver function tests (LFTs), which is a misnomer as they do not actually measure or indicate liver function. Rather, these tests should be referred to as liver enzyme tests, with the term LFTs reserved to refer to measures of hepatocyte synthetic function such as serum albumin and prothrombin time (PT). Any single biochemical test provides limited information, which must be placed in the context of the entire clinical and historic picture. Currently available laboratory evaluative tests of the liver are used to (1) screen for and document liver injury; (2) identify the type or pattern of liver disorder and the site of injury; (3) prognosticate and follow up children with chronic liver disease; and (4) serially monitor the course of liver disease, evaluate the response to treatment, and adjust a treatment regimen when appropriate.

The widespread availability and frequent use of serum chemistry tests in children have resulted in an increase in the number of both normal and abnormal liver chemistry test values that must be evaluated by physicians. However, some limitations of liver biochemical tests must be recognized [1].

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Chapter
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Liver Disease in Children , pp. 163 - 176
Publisher: Cambridge University Press
Print publication year: 2007

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