Abnormal Liver Function Tests (LFTs)

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and include in particular:

  • Duration of symptoms including reason for testing
  • Alcohol history, illicit drug use, recent piercings, tattoos
  • Weight and BMI
  • Current and past medications
  • Family history especially haemochromatosis, Wilson's disease
  • Overseas travel

Consider also information on: Hepatitis C

Tests

Initial work up:

  • Viral Hepatitis serology including:
    • Hep A IgM, Hep B sAg, Hep B cAg, HCV Ab
  • Immunoglobulins
  • Autoantibodies (ANA, SMA, AMA)
  • Iron studies
  • Copper and caeruloplasmin
  • Lipid profile
  • Blood glucose
  • Ultrasound upper abdomen

For known Hepatitis B:

  • Hep B eAg, Hep B eAb

Please include prior blood results if available.

Interim/GP management

To refer a patient with this condition, please see the Gastroenterology clinic page for the full referral process and templates.

For more information please see the Tasmanian Health Pathways website.

Emergency

Cholangitis (pain, fever and jaundice)

Urgent / category 1

Jaundice

ALT>400 or documented acute onset hep A, B or C

Decompensated liver disease:

  • Ascites
  • Peripheral oedema
  • Wasting

Suspected malignancy or liver mass on imaging

Semi-urgent / category 2

  • Hepatitis B with   ALT>100
  • Clinical concern that there is significant chronic liver disease
  • Abnormal LFTs with no cause found (BMI normal)
  • Liver diagnosis for initial management e.g.
    • Suspected or proven primary biliary cirrhosis
    • Haemochromatosis
    • Alcoholic CLD
    • Autoimmune hepatitis

Routine / category 3

  • Hepatitis B with ALT <100
  • Probable non-alcoholic steatohepatitis (NASH)
  • Abnormal LFTs despite lifestyle change and weight loss

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6426 5115
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6430 6691
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6222 8919

Urgent:

We will endeavour to see these patients within four weeks

Urgent referrals should be accompanied by a phone call to the clinic and the relevant doctor for urgent assessment, or patient should be directed immediately to the Emergency Department.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment