Hepatic function testing

The clinical situation determines the choice of hepatic function tests. Alkaline phosphatase (ALP) and aspartate aminotransferase (GOT) tests serve to detect disease, and when used in combination with a gammaglutamyl transferase (GGTP) test, to exclude it. The combination of ALP, GOT, bilirubin, lactate dehydrogenase (LDH), albumin, globulin, and GGTP tests is useful for routine differential diagnosis. Prothrombin time indicates severity of disease. Interpretation is facilitated by attention to ALP or GOT predominance; the relationship of LDH, ALP, and bilirubin; and the ratio of GGTP to ALP. Abnormalities on routine tests frequently do no more than point out the need for more definitive procedures.