Abnormal liver function tests

Abnormal liver function tests — referral criteria for Gastroenterology services.

Full SRC reference

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed abnormal liver function tests with initial primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Acute liver failure

Severe hepatic encephalopathy

Aspartate transaminase (AST) greater than 2,000 units per litre

Routine referral criteria

Determine Category 2 or 3 urgency.

Abnormal liver function tests with — platelet count less than 120 x 109per litre

Abnormal liver function tests with — splenomegaly

Abnormal liver function tests with — ascites

Abnormal liver function tests with — hepatic encephalopathy

Abnormal liver function tests with — genetic haemochromatosis (C282Y homozygotes and C282Y/H63D compound heterozygotes only)

Abnormal liver function test with aspartate transaminase (AST) or alanine aminotransferase (ALT) greater than or equal to 5 times the upper level of the normal range

Two abnormal liver function test results performed at least 3 months apart with aspartate transaminase (AST) or alanine aminotransferase (ALT) 2-5 times the upper level of the normal range

Usually managed in primary care

Fatty liver with normal liver function tests