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ALT is a blood test that determines the level of the enzyme alanine
transaminase (ALT) in the blood often part of an initial screening for liver
The liver plays several important roles: It stores fuel from food, maes
proteins, and helps remove to!ins from the body. The liver also maes bile, a
"uid that helps in digestion. #roteins called enzymes help the liver build and
brea do$n proteins. ALT (or %&#T, $hich stands for serum glutamic'pyruvic
transaminase) is one of these enzymes. It(s found in particularly large
amounts in the liver and plays an important role in metabolism, the process
that converts food into energy.
)ormally, ALT is found inside liver cells. *ut if the liver is in"amed or in+ured,
ALT is released into the bloodstream. ,easuring blood levels of ALT can give
doctors important information about ho$ $ell the liver is functioning and
$hether a disease, drug, or other problem is a-ecting it.
Why It's Done
The ALT test may be ordered if you are e!periencing symptoms of liver
disease, including +aundice (yello$ish sin or eyes), dar urine, nausea,
vomiting, or abdominal pain. It may also be ordered to help diagnose
infections of the liver such as viral hepatitis (ALT levels are high $ith acute
hepatitis) or to monitor patients taing medications that cause liver'related
side e-ects.
The ALT test is often performed as part of a full hepatic function panel that
includes other liver enzyme tests. Looing at ALT levels along $ith those of
other liver enzymes . such as aspartate aminotransferase (A%T) and alaline
phosphatase (AL#) . can give doctors more speci/c information about liver
Preparation & Expectations
What is ino!e" in preparation #or the test$
&enerally, no preparation is needed for an ALT blood test. Test is performed in
blood serum the only information re0uired is the drugs you are taing
because there are certain drugs that alter the ALT levels.
Res%!ts an" &a!%es
What "o the test res%!ts 'ean$
)ormally, ALT levels range from 1 to 23 units per liter (45L). 6levated levels of
ALT may indicate one of the follo$ing conditions:

hepatitis, or in"ammation of the liver disease
alcoholic liver
cholestasis, or congestion of the bile ducts
cirrhosis, or scarring of the liver $ith loss of function
death of liver tissue
cancer of the liver
noncancerous tumor of the liver
use of medicines or drugs to!ic to the liver
The ALT test is considered a safe procedure. 7o$ever, as $ith many medical
tests, some problems can occur $ith having blood dra$n:
fainting or feeling lightheaded
hematoma (blood accumulating under the sin causing a lump or
pain associated $ith multiple punctures to locate a vein
The reaction system is as follows:
L-alanine + 2-oxoglutarate---------------- pyruvate + L-glutamate
Pyruvate + !DH + H
------------------ l-lactate + !D
Buffer: T"#$ %uffer solution& pH '() with L-alanine
Substrate: *ials containing 2-oxoglutarate& re+uce+ !DH an+ LDH
Provi+e+ reagents are rea+y to use( They may %e use+ separately or as Monoreagent
mixing , parts -uffer an+ . part $u%strate(
Co!!e"t#on: /ollect anticoagulate+ %loo+(
A$$#t#%es: 0se concentrate+ 1DT! anticoagulants or +rie+ %alance
Stab#!#t& an$ storage #nstru"t#ons: !LT in serum is sta%le in refrigerator up to 2
+ays without preservatives( Do not free3e(
RE'UIRED MATERIAL (non) *ro%#$e$+:
4icropipettes an+ pipettes for measuring the state+ volumes(
$pectrophotometer cuvettes or Photo colorimeter tu%es(
5atch or timer(
5ater %ath
-a%e)!engt.: 2,6nm
Rea"t#on te/*erature: 2)& 26 or 2'
Rea"t#on t#/e: , min(
Sa/*!e %o!u/e: .66 7l(
$ample an+ reagent volumes may %e proportionally change+ without altering the
correspon+ing calculation factors(
#n a cuvette at 26-2'
/& place:
Monoreagent .(6ml
Preincu%ate for a few minutes& an+ then a++:
Sa/*!e .66 7l
4ix imme+iately an+ simultaneously start stop watch( !fter 86 secon+s recor+ initial
a%sor%ance an+ then at .& 2 an+ 2 minutes after the first rea+ing( Determine average
change in a%sor%ance9min :;!9min<& su%tracting each rea+ing from the previous one an+
averaging these values( 0se this mean for calculations(
!. =
!2 =
!2 =
!, =
;! = :!2 > !.< + :!, >!2<
!LT:09l< = ;!9min ? factor :factor = .',@<