Laboratory values/blood values

The determination of various laboratory parameters is essential for the diagnosis and treatment planning of liver failure. First of all, a distinction is made between parameters that indicate liver tissue damage and those that detect a synthesis disorder (production of enzymes and proteins) in the liver. In addition, further blood values are used to assess the severity of the disease.

To assess the tissue damage of the liver, the so-called transaminases (GPT and GOT), GLDH, alkaline phosphatase, gamma-GT, bilirubin and ammonia are determined. These parameters can be elevated to varying degrees and provide some information about the cause of liver insufficiency. The gamma-GT is elevated, for example, in the case of alcohol damage, whereas an increase in alkaline phosphatase can be an indication of the presence of biliary cirrhosis.

The standard values can be taken from your laboratory findings, as these are included as standard.To assess the synthesis performance of the liver, the quick value and INR, albumin and total protein as well as cholinesterase are determined. The quick-value and INR are parameters for coagulation in human blood. In case of liver failure, the quick-value may be decreased and the INR increased.

These changes are caused by the synthesis of coagulation factors in the liver. In liver failure, they are reduced. The albumin is also reduced, since this too is no longer produced sufficiently in the liver.

Cholinesterase serves as a progression parameter in chronic liver diseases and is also reduced in liver failure. In the blood count, for example, thrombocytes can be reduced (thrombocytopenia) and anemia (for example, vitamin B 12 deficiency) in the context of liver cirrhosis. In hepatic encephalopathy, special attention is paid to the determination of ammonia, glucose and electrolytes (e.g. potassium). In a hepatorenal syndrome there is an increase in serum creatinine.

Child-Pugh

The Child-Pugh criteria are used to assess the prognosis of liver cirrhosis. They are used to adjust therapy and to better assess patient survival. There are five categories.

Between one and three points are awarded for each category. The individual categories that are evaluated are albumin concentration in serum (g/dl), bilirubin concentration in serum in mg/dl, quick value in % as well as the presence and severity of ascites (water in the abdomen) and hepatic encephalopathy. The albumin, bilirubin and quick-value are a measure of how well the liver fulfils its metabolic and synthetic functions.

In hepatic insufficiency, the Quick and albumin are decreased and the bilirubin is increased. Ascites and hepatic encephalopathy are the consequences of liver failure and also indicate how severely liver function is impaired. There are three stages of the Child-Pugh classification, namely Child A (5-6 points), Child B (7-9 points) and Child C (10-15 points). The higher the score, the worse the prognosis of the patient.