Evaluation of Hepatic Function and Injury

The liver is responsible for many vital physiologic functions essential for the maintenance of normal homeostatic mechanisms. It has a remarkable capacity for storage, synthesis, and regulation of a wide variety of substances. In addition, the liver has substantial functional reserve and regenerative capabilities. Because of its important role in preservation of a biologic system, it is prone to injury from a wide variety of toxic, infectious, and metabolic disturbances. The changes in liver functional capacity or detection of disease or injury can be determined using laboratory tests. This chapter highlights the major functions of the liver and the clinical chemistry endpoints/parameters used for detecting the liver pathology and/or functional capabilities. The liver has many diverse and important physiologic functions. In general, these functions involve storage, synthesis/metabolism, and excretion/transport. The liver plays a large role in the synthesis and metabolism of a wide variety of endogenous and exogenous substances.