What are the results of a liver function panel (LFP) blood test?

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Last updated: April 30, 2025 • View editorial policy

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From the Guidelines

A liver panel blood work should include tests for bilirubin, albumin, alanine aminotransferase (ALT), alkaline phosphatase (ALP), and γ-glutamyltransferase (GGT), as recommended by the guidelines on the management of abnormal liver blood tests 1. This panel of tests provides a comprehensive assessment of liver health and function, and can help diagnose conditions such as hepatitis, cirrhosis, fatty liver disease, or medication-induced liver injury. The test involves a simple blood draw from a vein in the arm, which takes only a few minutes, and results are typically available within 1-3 days. It is essential to interpret abnormal liver blood test results in the context of the patient's medical history and current condition, as the extent of liver blood test abnormality is not necessarily a guide to clinical significance 1. In adults, a standard liver aetiology screen should include abdominal ultrasound scan, hepatitis B surface antigen, hepatitis C antibody, anti-mitochondrial antibody, anti-smooth muscle antibody, antinuclear antibody, serum immunoglobulins, simultaneous serum ferritin and transferrin saturation 1. For patients with non-alcoholic fatty liver disease (NAFLD), risk stratification to determine the extent of liver fibrosis is crucial, and first-line testing should use either fibrosis-4 (FIB-4) or NAFLD Fibrosis Score (NFS) 2. Key components of a liver panel blood work include:

  • Bilirubin
  • Albumin
  • Alanine aminotransferase (ALT)
  • Alkaline phosphatase (ALP)
  • γ-glutamyltransferase (GGT)
  • Abdominal ultrasound scan
  • Hepatitis B surface antigen
  • Hepatitis C antibody
  • Anti-mitochondrial antibody
  • Anti-smooth muscle antibody
  • Antinuclear antibody
  • Serum immunoglobulins
  • Simultaneous serum ferritin and transferrin saturation. It is also important to note that the current reference intervals for ALT may be too high, as suggested by emerging literature 1. Overall, a liver panel blood work is a valuable tool for assessing liver health and function, and should be interpreted in the context of the patient's medical history and current condition, with consideration of the latest guidelines and recommendations 1, 2.

From the Research

Liver Panel Blood Work

  • Liver biochemical tests are commonly ordered routine tests in both inpatient and outpatient settings, and include:
    • Aminotransferases
    • Alkaline phosphatase
    • Gamma-glutamyl transferase
    • Bilirubin
    • Albumin
    • Prothrombin time and international normalized ratio (INR) 3
  • Abnormal liver biochemical tests can be categorized into two main patterns:
    • Hepatocellular pattern
    • Cholestatic pattern 3, 4
  • Hepatocellular pattern causes include:
    • Non-alcoholic fatty liver disease/non-alcoholic steatohepatitis
    • Alcohol use
    • Chronic viral hepatitis
    • Liver cirrhosis (variable)
    • Autoimmune hepatitis
    • Hemochromatosis
    • Wilson's disease
    • Alpha-1 antitrypsin deficiency
    • Celiac disease
    • Medication-induced and ischemic hepatitis 3
  • Cholestatic pattern causes include:
    • Biliary pathology (obstruction, autoimmune)
    • Other conditions with hyperbilirubinemia (conjugated and unconjugated) 3
  • Evaluation of abnormal liver chemistries should include:
    • Testing for viral hepatitis A, B, and C
    • Assessment for nonalcoholic fatty liver disease and alcoholic liver disease
    • Screening for hereditary hemochromatosis, autoimmune hepatitis, Wilson's disease, and alpha-1 antitrypsin deficiency
    • History of prescribed and over-the-counter medicines 4
  • A liver biopsy may be considered when serologic testing and imaging fails to elucidate a diagnosis, to stage a condition, or when multiple diagnoses are possible 4

References

3
Research

Abnormal liver enzymes: A review for clinicians.

World journal of hepatology, 2021

4
Research

ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries.

The American journal of gastroenterology, 2017

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