More A Patient’s View of Blood Tests and What They Mean for the Liver Transplant Candidate

What do elevated liver tests (AST and ALT) mean?

AST (SGOT) and ALT (SGPT) are sensitive indicators of liver damage or injury from different types of disease. But it must be emphasized that higher-than-normal levels of these liver enzymes should not be automatically equated with liver disease. They may mean liver problems or they may not. For example, elevations of these enzymes can occur with muscle damage. The interpretation of elevated AST and ALT levels depends upon the entire clinical evaluation of an individual, and so it is best done by physicians experienced in evaluating liver disease and muscle disease.

Moreover, the precise levels of these enzymes do not correlate well with the extent of liver damage or the prognosis (outlook). Thus, the exact levels of AST (SGOT) and ALT (SGPT) cannot be used to determine the degree of liver disease or predict the future. For example, individuals with acute viral hepatitis A may develop very high AST and ALT levels (sometimes in the thousands of units/liter range). But most people with acute viral hepatitis A recover fully without residual liver disease. To the contrary, people with chronic hepatitis C infection typically have only a little elevation in their AST and ALT levels. Some of these individuals may have quietly developed chronic liver disease such as chronic hepatitis and cirrhosis (advanced scarring of the liver).

It is, therefore, worth mentioning that these liver enzymes do not give an indication of the function of the liver. Sometimes they are mistakenly referred to as “liver function tests” or LFTs, but it is a misnomer commonly used even by most physicians.

Another blood test is the measurement of albumin in the blood. It is basically an indicator of how your system treats fluid retention or elimination in the body. Human serum albumin is the most abundant protein that is found in human blood plasma. This protein is produced in the liver and comprises around half of the blood serum protein. This protein has a serum half life of around twenty days. If you have too much fluid retention then you bloat up, especially around the feet, ankles, legs (called edema), and the abdominal area (called ascites).

Anion Gap, another blood test is basically the difference between Sodium + Potassium minus Bicarbonate + Chloride. Anion Gap measurements are generally lower in patients with lower albumin levels that have cirrhosis. These lower measurements mean the blood is less acidic, which I have no idea of what that means.

The best I could conclude is that lower anion gap levels that are associated with lower albumin levels are strongly associated with cirrhosis.