Intelligent liver disease detection test developed

Potential to save thousands of lives amid ‘liver failure epidemic’ as test trial shows 44% increase in diagnosis

Tuesday 25th June 2019

A new type of test has been developed in Tayside that can detect liver disease at an early stage, potentially saving thousands of lives.

Professor John Dillon, consultant gastroenterologist and hepatologist, and Dr Ellie Dow, consultant in biochemical medicine, worked with colleagues from NHS Tayside and the University of Dundee to develop the intelligent liver function tests (iLFTs) using the automated blood sciences laboratory infrastructure at Ninewells Hospital.

Liver function is routinely investigated by testing blood samples requested by GPs.

Results commonly show abnormal liver function but this is often under-investigated due to the many different and complex reasons for an abnormal result.

The opportunity to diagnose and treat the disease at an early stage can therefore be missed.

Using advances in laboratory technology, Professor Dillon and Dr Dow’s team created the new iLFTs that see more tests automatically carried out on a patient’s blood sample if there is a suspected liver disorder or abnormal results with no clear explanation. 

GPs receive the results along with 32 potential outcomes, making it easier to identify the cause of liver dysfunction and give a firm diagnosis. 

This is complemented with lifestyle advice for those who need it, while those with advanced or complex disease are referred for further treatment.

Initial results from the iLFT trial showed a 44% increase in diagnosis of liver disease, giving patients earlier access to treatment. 

Since being launched in NHS Tayside in June last year more than 2,500 patients have been tested, with 30% of these showing abnormal results. 

The tests have now been made standard practice across NHS Tayside and the Scottish Government’s modern outpatient programme is considering whether this could be rolled out across Scotland.

“We’ve been predicting that a liver failure epidemic has been coming but now we are seeing hard-evidence that it is already here,” says Professor Dillon.

“What we are seeing now is a huge increase in the number of people with alcohol-related or obesity-related liver diseases, and at a far more advanced stage than previously predicted.

“We have also been surprised to see the number of people with significant liver scarring which is likely to become liver failure in 10 or 15 years’ time if we do not act now. Liver disease is a silent killer, it creeps up on you, so it is crucial that we find a way to detect it earlier and switch off this ticking time bomb.

“By working with the existing IT systems in the lab, we were able to develop a system that detects the early warning signs of liver disease and which can then give GPs the tools they need to make a solid diagnosis and begin treatment plans.

“More importantly, our modification allows us to immediately differentiate between alcoholic or non-alcoholic fatty liver disease and the more rare diseases such as autoimmune liver diseases Hepatitis C or metabolic diseases, meaning those who need immediate assistance receive it faster.

“We hope that with continued tests, people drinking too much or eating high-fructose sugars can make the lifestyle changes now that will reduce the numbers coming into hospital with fatal liver failure in the years to come.”

Jeane Freeman, Cabinet Secretary for Health & Sport, said: “This is an innovative piece of work that is using technology to bring a real improvement to patients’ outcomes.

“Early detection is absolutely key to successful treatment. I would like to congratulate the team at the University of Dundee and NHS Tayside for their valuable work in this area.”

 

Pictured: The iLFT team at Ninewells Hospital in Dundee including Professor Dillon (centre, back) and Dr Dow (second right)