AST and Platelets with APRI

CPT: 84450; 85049
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Test Details


AST to Platelet Ratio Index (APRI) is reported to be a simple, noninvasive, and readily available laboratory test index that can stratify patients with HCV and Non-Alcoholic Fatty Liver Disease (NAFLD) who are at high or low risk for significant fibrosis and cirrhosis with high degree of accuracy.


Clumping may cause false low count. Platelet satellitism around neutrophils will cause a pseudothrombocytopenia. RBC or WBC fragments including fragmented fragile leucemic cells and neutrophil pseudoplatelets may cause falsely elevated counts.


AST: kinetic; Platelet Count: automated cell counter

Specimen Requirements


Serum and whole blood


0.5 mL (serum); fill tube to capacity (whole blood)

Minimum Volume

0.5 mL (serum), 0.5 mL (whole blood)


Gel-barrier tube or red-top tube and lavender-top (EDTA) tube


Separate serum from cells within 45 minutes of collection; invert EDTA tube immediately 8 to 10 times once tube is filled at the time of collection.

Storage Instructions

Room temperature

Stability Requirements



Room temperature

1 day


3 days



Freeze/thaw cycles


Causes for Rejection

Serum: gross hemolysis; improper labeling

Whole blood: hemolysis; clotted specimen; tube not filled with minimum volume; improper labeling; transfer tubes with whole blood; specimen diluted or contaminated with IV fluid; specimen received with plasma removed; specimen collected in any anticoagulant other than EDTA

Clinical Information


Angulo P, Bugianesi E, Bjornsson ES, et al. Simple noninvasive systems predict long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology. 2013 Oct;145(4):782-789.23860502
Boursier J, Vergniol J, Guillet A, et al. Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in nonalcoholic fatty liver disease. J Hepatol. 2016 Sep;65(3):570-578.27151181
Chou R, Wasson N. Blood tests to diagnose fibrosis or cirrhosis in patients with chronic hepatitis C virus infection: a systematic review. Ann Intern Med. 2013 Jun 4;158(11):807-820.23732714
Lin ZH, Xin YN, Dong QJ, et al. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. Hepatology. 2011 Mar;53(3):726-736.21319189
Rinella ME, Sanyal AJ. Management of NAFLD: a stage-based approach. Nat Rev Gastroenterol and Hepatol. 2016 Apr;13(4):196-205.26907882
Sanyal A, Ratziu V, Goodman Z, et al. 507 APRI and FIB-4 index scores can enrich for subjects with fibrotic nonalcoholic steatohepatitis (NASH) in Clinical Trials - The CENTAUR trial data. Gastroenterol. 2016 Apr;150(4)Supp1:S1037-S1038.10.1016/S0016-5085(16)33508-9
Shaheen AA, Myers RP. Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C-related fibrosis: a systematic review. Hepatology. 2007 Sep;46(3):912-921.17705266
Tapper EB, Krajewski K, Lai M, et al. Simple non-invasive biomarkers of advanced fibrosis in the evaluation of nonalcoholic fatty liver disease. Gastroenterol Rep (Oxf). 2014 Nov;2(4):276-280.25002154


Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
385375 AST and Platelets with APRI 001123 AST (SGOT) IU/L 1920-8
385375 AST and Platelets with APRI 011579 APRI Index 86465-2
385375 AST and Platelets with APRI 015172 Platelets x10E3/uL 777-3

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