Test ID: ELF S

Enhanced Liver Fibrosis (ELF), Serum

Test Overview

Clinical Utility

The ELF (Enhanced Liver Fibrosis) test is indicated, with other laboratory results and clinical evaluations, to assess the severity of liver fibrosis in patients with signs, symptoms, or risk factors of chronic liver disease.

Method

Chemiluminescent immunoassay (CLIA)

Method Description

The ELF score is based on the combined quantitative measurements of Hyaluronic acid, N-terminal propeptide type III procollagen (PIIINP) and Tissue inhibitor of matrix metalloproteinase 1 (TIMP-1).

Result Included

Enhanced Liver Fibrosis (ELF) Score

Aliases/Synonyms

ELF Score

Specimen

Specimen Type

Serum

Containers

Collection Containers

Gold top (clot activator & gel)

Volume

Sample Volume

1.0 mL

Minimum Volume

0.5 mL

Patient Preparation

Biotin supplementation exceeding 5000 mcg/day may skew analytical results. Discontinue supplementation 72 hours prior to sample collection.

The fluorescein used in retinal angiography can persist in the bloodstream and may interfere with analytical results. Wait at least 72 hours after the procedure before collecting the sample.

Collection & Handling

Handling Information

Spin and transfer serum to polypropylene transfer vial. Store and send frozen.

Stability

Ambient	Refrigerated	Frozen
2 days	7 days	12 months

Rejection Criteria

Criteria	Specification
Hemolysis	Present

Performance & Interpretation

Turnaround Time

8 days

Results

Enhanced Liver Fibrosis (ELF)

Score

< 9.8 ELF score ranges and associated risk of disease progression (development of cirrhosis or liver-related events):
Lower: <9.80
Mid: 9.80 to 11.29
Higher: ≥11.30

Comment

The ELF score is based on the combined quantitative measurements of hyaluronic acid, amino terminal propeptide of type III procollagen and tissue inhibitor of matrix metalloproteinase 1.

Biotin supplementation exceeding 5000 mcg/day may skew analytical results. Discontinuing supplementation is recommended 72 hours prior to sample collection.

The fluorescein used in retinal angiography can persist in the bloodstream and may interfere with analytical results. It is recommended to wait at least 72 hours after the procedure before collecting the sample.

Referral Location

Canada

Interface & Setup

HL7 Interface Codes

Order Code	Result Name	Result Codes	Units
ELF S	ELF	66242

Test Version

Last Updated

2025-09-30