Approach to Liver Function Tests in Children

The liver is a multifactorial organ which is involved in a number of critical excretory, synthetic and metabolic functions. Although the term 'liver function test' is commonly used, it is imprecise since many of the tests, such as transaminase, do not measure liver function. Therefore, these tests should be referred to as 'liver enzyme tests', and 'liver function tests' should be the term used to measure hepatocyte synthetic functions, such as serum albumin and prothrombin time. Furthermore, commonly used biochemical tests may be normal in a patient with liver disease (compensated cirrhosis) or be abnormal in a case with a healthy liver. In this article different aspects of liver function tests and the approach to abnormal liver function tests are reviewed.