Liver function tests and assessment of liver function

Abstract Liver inspection was used in ancient times to predict health and the future. In the twentieth century, the value of serum transaminases and bilirubin was determined in the diagnosis of liver disease. Assessment of global hepatic function can be achieved using biochemical testing of the liver alone or in combination with complications of portal hypertension. However, measurement of liver enzyme levels does not reflect liver function, therefore it is recommended to use the term liver biochemical tests rather than liver function tests. These tests include serum bilirubin, transaminases, alkaline phosphatase, gamma-glutamyl transferase, and 5′-nucleotidase. They have many clinical applications and are essential non-invasive tools to evaluate liver diseases, determine severity and progression, and measure treatment outcomes. Albumin and prothrombin time are important tests of hepatic synthetic function. Dynamic tests of liver performance are non-invasive tools that are described in the literature but are rarely used in clinical practice.