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Chapter 7 - Laboratory Assessment of Liver Function and Injury in Children

from Section I - Pathophysiology of Pediatric Liver Disease

Published online by Cambridge University Press:  19 January 2021

By
Vicky Lee Ng
Edited by
Frederick J. Suchy ,
Ronald J. Sokol  and
William F. Balistreri
Edited in association with
Jorge A. Bezerra ,
Cara L. Mack  and
Benjamin L. Shneider
Frederick J. Suchy
Affiliation:
University of Colorado, Children’s Hospital Colorado, Aurora
Ronald J. Sokol
Affiliation:
University of Colorado, Children’s Hospital Colorado, Aurora
William F. Balistreri
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati
Jorge A. Bezerra
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati
Cara L. Mack
Affiliation:
University of Colorado, Children’s Hospital Colorado, Aurora
Benjamin L. Shneider
Affiliation:
Texas Children’s Hospital, Houston
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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 utilized serum chemistry tests, like aminotransferase and alkaline phosphatase levels, are often referred to as liver function tests (LFTs), which is a misnomer, as these do not actually measure or indicate liver function. Rather, these tests should be referred to as liver enzyme tests, reserving the term LFTs to refer to measures of hepatocyte synthetic function such as international normalized ratio (INR), prothrombin time (PT) or serum albumin. Any single biochemical test provides limited information, which must be placed in the context of the entire clinical and historic picture. Currently, the most commonly 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. Tests to evaluate liver disease can be divided into five categories (Table 7.1)

Type
Chapter
Information
Liver Disease in Children , pp. 94 - 106
Publisher: Cambridge University Press
Print publication year: 2021

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