Which of the following statements regarding liver enzymes is true
Correct Answer: Glutathione-S- Transferase is used as a hepatic prognostic marker after surgery
Description: Answer is C (Glutathione-S- Transferase is used as a hepatic prognostic marker after surgery) Glutathione - S - Transferase is an emerging enzyme marker for post-transplant monitoring (surgery) as an aid to the diagnosis of acute allagraft rejection ALT is a more specific indicator of liver injury than AST and absolute levels of aminotransferase do not correlate with outcome. ALT is a more specific indicator of Liver injury than AST AST (Aspaate Aminotransferase) is found in the liver, cardiac muscle, skeletal muscle, kidneys, brain, pancreas, lung, leukocytes and erythrocytes in decreasing order of concentration. ALT is found primarily in the liver and is therefore a more specific indicator of Liver injury - Harrison's 186/2528 Absolute level of Aminotransferase elevation do not correlate with outcome `There is poor correlatation between extent of Liver cell Necrosis and the elevation of serum aminotransferase levels in chronic liver diseases. Similarly, absolute elevation of aminotransferase levels is of little value in predicting the outcome of acute hepatocellular disorders' - Schiff's Deseases of the Liver Serum Glutathione - S- Transferase may be used as a prognostic marker after transplant surgery 'Serum Alpha - Glutathione - S - Transferase is an emerging static test indicating hepatocellular damage. As in vivo plasma half life of this enzyme is less than 60-90 minutes, this enzyme offer advantages in post-transplant monitoring as an aid to the diagnosis of acute allagraft rejection. Recent investigations have indicated that monitoring of GST reduced both moality and morbidity in liver transplant recipients. GST showed a distinct higher sensitivity (81%) for acute rejection than conventional liver function tests (the specificity however was relatively low (45%). Glutathione - S-Transferase (GST) - Miller's Anesthesia (Elsevier) 2010/426 Glittathione-S-Transferase is a sensitive and specific test for some patterns of Liver injury. The enzyme has a brief plasma half life (90 minutes) and is released rapidly into circulation following hpatocellular injury. Thus serial GST measurements can reveal time course of hepatic injury from its onset to its resolution. In contrast to AST and ALT which reside in Acinar Zone I, GST localizes in Acinar Zone III (centrilobular region). This zone contains the hepatacyte population with highest susceptibility to injury from hypoxia or reactive drug metabolites. Accordingly GST would be more sensitive than AST or ALT as a marker of contrilobular necrosis in its incipient stage.
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