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HelpOrder Code ELF Enhanced Liver Fibrosis (ELF), Serum
Specimen Required
Patient Preparation: For 12 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL Serum
Collection Instructions: Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial. Specimens that have not been aliquoted will be rejected.
Forms
If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Test Request (T728) with the specimen.
Useful For
As a prognostic marker in conjunction with other laboratory findings and clinical assessments to assess the likelihood of progression to cirrhosis and liver-related clinical events in patients with advanced fibrosis (F3 or F4) due to metabolic dysfunction-associated steatohepatitis (MASH)
Method Name
Direct Chemiluminescent Immunoassay
Reporting Name
ELF (Enhanced Liver Fibrosis), SSpecimen Type
SerumSpecimen Minimum Volume
Serum: 0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 7 days |
| Frozen | 365 days | |
| Ambient | 48 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
|
ELF score |
Risk of disease progression |
|
≥9.20 |
Diagnostic cut-off for clinically significant fibrosis (fibrosis stage 2 or greater) |
|
≥11.30 |
Prognostic cut-off for higher risk of progression to liver-related clinical events |
Method Description
The enhanced liver fibrosis (ELF) score uses the measured concentrations of hyaluronic acid (HA), amino-terminal pro-peptide of type III procollagen (PIIINP), and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), abbreviated as CHA, CPIINP, and CTIMP-1, respectively, in the equation below. Testing is performed using the fully automated ADVIA Centaur instrument with the ADVIA Centaur HA, ADVIA Centaur PIIINP, and ADVIA Centaur TIMP-1 reagents. These reagents are based on 2-site sandwich assay methodology and direct chemiluminescent technology. The concentrations of HA, PIIINP, and TIMP-1 are not reported individually.(Package insert: Advia Centaur XPT ELF. Siemens Healthcare Diagnostics Inc.; 11205858_EN Rev. 02, 10/2022)
The ELF score is calculated from the concentration of the 3 measured analytes using the following equation:
ELF (score) = 2.278 + 0.851 ln(CHA) + 0.751 ln(CPIIINP) + 0.394 ln(CTIMP-1)
Day(s) Performed
Monday through Friday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
81517
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ELF | ELF (Enhanced Liver Fibrosis), S | 88055-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| ELFSC | ELF Score | 88055-9 |