In a major relief to paediatric Non-Alcoholic Fatty Liver Disease (NAFLD) patients, a new blood test could become clinical practice within five years, reducing the need for a liver biopsy in the patients. The study is being presented at the 52nd Annual Meeting of ESPGHAN in Glasgow.Liver biopsy is currently the most accurate test for NAFLD and the only method routinely used in practice for assessing the presence of scarring or inflammation. However, a biopsy is invasive, resource intensive, costly, prone to sampling error and carries a small risk of significant complications. Therefore, the availability of an accurate and non-invasive marker to replace the need for liver biopsy, both in routine practice and in a clinical trial setting, is a major breakthrough for children, parents and healthcare professionals.This research is the first major finding to be reported from the European Paediatric Non-Alcoholic Fatty Liver Disease Registry (EU-PNALFD registry). “It is early but the results of the research are promising and could help shift the way we understand and manage paediatric NAFLD: saving resources, time and stress for children and their parents. The new multi-centre registry provides us with an opportunity to tackle these challenges,” said Dr Jake Mann, lead author of the study.”The EU-PNAFLD registry will facilitate recruitment into interventional clinical trials as well as imaging, biomarker, and translational studies, plus allow greater understanding of the long-term natural history of NAFLD. The ultimate aim is to understand the condition sufficiently to intervene and slow disease progression so we can reduce the number of patients requiring liver transplantation later in life.”The study looked at 67 children with NAFLD and found that different types of fats in the blood were associated with features of fatty liver on liver biopsy, allowing researchers to determine the presence of inflammation and scarring – also known as non-alcoholic steatohepatitis and fibrosis.Non-Alcoholic Fatty Liver Disease affects one in 10 children and is the most common paediatric liver disorder. It can progress to advance scarring (cirrhosis), liver failure and liver cancer.