title: AST 17600 U/l after liver transplantation, what are you up to? - A case report.
abstract: BACKGROUND
  Miscellaneous clinical classifications of liver function after liver transplantation are rested upon elevation of transaminases which represent damaging of hepatocytes and with it of the liver.
  
  
  METHODS
  We report the case of a 35-year-old man suffering from hepatocellular carcinoma in the setting of alcoholic liver cirrhosis. The patient underwent liver transplantation and developed an extreme peak of transaminases due to prolonged cold ischemia time and additional extended donor criteria. On the first postoperative day the laboratory results showed peak transaminases as follows: AST 17577 U/l and ALT 9884 U/l. Frequent ultrasound revealed no signs of vascular complications. In spite of the dramatically elevated transaminases the liver showed a good primary function and the patient was cardiopulmonary stable. The entire postoperative course was uneventful. We discharged the patient after three weeks in a very good general state of health, with normal laboratory values.
  
  
  CONCLUSIONS
  Exclusive extreme elevation of transaminases after liver transplantation combined with adequate liver synthesis does not always require re-transplantation, if situation of the patient is stable. Nevertheless re-transplantation should be reconsidered in any case of clinical deterioration of the patient.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. dieter.hoyer@uk-essen.de
authors.forename: Dieter Paul
authors.initials: DP
authors.lastname: Hoyer
authors.forename: Gernot Maximilian
authors.initials: GM
authors.lastname: Kaiser
authors.forename: Jürgen Walter
authors.initials: JW
authors.lastname: Treckmann
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Mathe
authors.forename: Fuat
authors.initials: F
authors.lastname: Saner
authors.forename: Sonia
authors.initials: S
authors.lastname: Radunz
authors.forename: Agnes
authors.initials: A
authors.lastname: Bankfalvi
authors.forename: Anja
authors.initials: A
authors.lastname: Gallinat
authors.forename: Thomas
authors.initials: T
authors.lastname: Minor
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery; D050377:Cold Ischemia / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000601:surgery; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D014019:Tissue Donors; D014463:Ultrasonography
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase