Abnormal LFTs may indicate a specific liver disease process e.g. ongoing liver cells damage or impaired function of liver.

The improvement or normalisation of LFTs however don’t always equate to full recovery to a normal liver. The liver has the ability to regenerate, to provide an increased reserve of functioning cells, but established architectural damage of liver may be present. A liver biopsy is an useful but invasive test, to help make a diagnosis and assess the damage.

Once a diagnosis is made, the focus will be an assessment of any established liver damage. The options include non-invasive blood tests (ELF), scoring systems derived from simple clinical and labarotory parameters (NAFLD score), or a liver fibroscan. These tests are invaluable in the assessment of liver scarring (fibrosis or cirrhosis).

Upside: The test is quick, painless and easily repeatable.
Downside: Validated for specific liver conditions. Assess scarring (fibrosis or cirrhosis) or build-up of fat (steatosis). No specific information on underlying liver disease state or function. Sampling error. Body habitus limitation.