Abnormal Liver Function Tests (LFTs)

The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form.  This is part of routine waitlist auditing to ensure patient details are up to date.  If you receive this SMS, please update your details.

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply with referral standards and specifically include:

  • 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).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

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