Alanine transferase

This region has a higher concentration of the cytoplasmic enzyme alanine aminotransferase (ALT), which is thought to be more selective for liver injury. Aminotransferases can be highly elevated in acute cholestatic disease, particularly choledocholithiasis, although they are most helpful in the diagnosis (e.g., early stages of viral hepatitis) and monitoring of hepatocellular disease. Acute severe hypotension and acute heart failure can also cause notable increases.