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Hepatic Function Panel
(Liver)

What is a Hepatic Function Panel?

A Hepatic Function Panel or Liver Function Panel (LFP) is a group of analyte tests that evaluates the function of the liver. 

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Abnormal tests results can indicate if there is an infection, inflammation or injury to the liver.

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Analytes Tested in Hepatic Function Panels​

 

Liver Proteins

  • Albumin

  • Total Protein

Liver Enzymes

  • Alkaline Phosphatase (ALP)

  • Alanine Aminotransferase (ALT)

  • Aspartate Aninotransferase(AST)

Liver Metabolites

  • Total Bilirubin

  • Direct Bilirubin 

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Other Analytes that can be added to the panel:

Liver Enzymes:

  • Gamma-glutamyl transferase (GGT)

  • Lactate Dehydrogenase (LD)

Proteins

  • Alpha-fetoprotein (AFP)

What does the Liver Do?

  • Carbohydrate Metabolism

    • Storage of glucose as glycogen​

    • Gluconeogenesis

  • Protein Metabolism

    • Albumin (most abundant) & serum protein synthesiss​

    • Acute phase proteins

  • Metabolism of ammonia and urea synthesis

    • Catabolism of aminoacids to make ammonia, then detoxified​ & cleared

    • Remaining is converted to urea in the urea cycle

  • Lipid Metabolism

    • Fasting state: fatty acids & adipose tissue undergo beta-oxidation for energy production​

    • Fed State: fatty acids undergo esterification to produce triglycerides

  • Conjugation, detoxification & excretion

    • Prevent toxic and harmful substances from reaching systemic circulation​:

      • Drugs, ​toxins & ammonia

  • Vitamin Storage

  • Digestion & formation of Bile

    • Bile acid synthesis form cholesterol:

      • Cholic & chenodeoxycholic ​

    • Metabolism of bile acids​

  • Synthesis of Coagulation Factors

  • Bilirubin Conjugation & Metabolism

Clinical Manifestations

of Liver Disease

  • Jaundice

    • Yellowing (icterus) of skin, mucous membranes & sclera caused by depositing of bilirubin

  • Altered Drug Metabolism

  • Nutritional & Metabolic Abnormalities

  • Disordered hemostasis

  • Release of enzymes in body fluids

Jaundice.jpg
Pathophysiology: Bilirubin Conjugation
Bilirubin Conjugation Pathophysiology.jp

What is Bilirubin

A natural metabolite created from the breakdown (catabolism) of heme in rbcs

  • Seen in rbc destruction (hemolysis)

Provides a yellow pigment to:

  • Bile​

  • Stool

  • Urine (but to a lesser degree)

Why Conjugate Bilirubin?

Bilirubin is a non-water soluble and toxic metabolite that can cause problems in large concentrations

  • Bilirubin in conjugated in liver to make it water water soluble.

  • This allows it to be excreted via the bile into the GI tract and then leaves the body through the feces as urobilinogen

Classification of Liver Problems
Prehepatic vs Hepatic vs Post Hepatic.jp

Where is the problem located? 

  • Pre-hepatic

  • Hepatic

  • Post-hepatic

Types of Jaundice.jpg

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Pre-Hepatic

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Hepatic

This is a great place to tell your story and give people more insight into who you are, what you do, and why it’s all about you.

Post-Hepatic

Sources:

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