Understanding the Intricacies of LFTs in Clinical Practice with Dr Chanika Ariyawansa

The Good GP

In this episode of The Good GP, hosts Dr Sean Stevens and Dr Tim Koh are joined by Dr Chanika Ariyawansa, a WA-trained chemical pathologist with additional training in genetic pathology. Dr Ariyawansa, who holds significant roles in the Australian Association of Clinical Biochemistry, delves into the nuances of liver function tests (LFTs), exploring patterns and implications of abnormal results.

Firstly, with an examination of the prevalence and general patterns of abnormal LFTs, highlighting the commonality of mild and transient abnormalities. Dr Ariyawansa clarifies common misconceptions regarding LFTs, emphasising that not all markers in the standard LFT panel are liver-specific or directly assess liver function.

They also explain in detail individual LFT components such as bilirubin, ALP, GGT, AST, and ALT. The guest expert also categorises potential abnormalities into hepatocellular, cholestatic, mixed, and non-hepatic causes, with practical insights on each. Special attention is given to non-hepatic causes, analytical causes, and how these might influence LFT interpretation.

Dr Ariyawansa's expertise shines as she discusses managing patient anxiety around abnormal LFT results and the practical aspects of educating patients about their liver health. She stresses the utility of resources such as the Pathology Tests Explained website for patient education.

Wrapping up with an engaging Q&A session addressing specific scenarios like non-drinking patients with isolated raised GGT and the impact of statins on LFTs. She answers with clinical relevance, offering listeners practical strategies for understanding and communicating complex test results in their practice.

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