Case 1.    Rule out rejection. Status post-OLT on 03/04 for biliary atresia; now with abnormal LFTs. (ALB:3.4 ALP:96 AST:70 ALT:225 plt:187 Bili T: 0.5 Bili Dr 0.1 Bili Ind 0.4 Prot Tot:7.8 transglut:6 Hep C titer <25, <1.39

Case 2. This patient is a 33-year-old female status post liver transplant in November of 1997 for AIH. ABL=3.9, AST=191, ALT=112, ALP=128, Tbili=3.1, Tprot=7.5. Rejection vs. recurrent autoimmune hepatitis. No other clinical information available.

Case 3. Status post liver transplant 10/31/2008 for etoh related cirrhosis. Rule out rejection. AST and ALT elevated in the 100s. Thymo started after biopsy and LFTs trending down. Total bili remains elevated and is up to 20 now.

Case 4. Thirty-nine year old with history of GERD dyslipidemia who was found to have abnormal LFTs one year ago, which was found in association with taking Zocor. Lab studies done 11/25/08 showed the following: AST=297, ALT=383, ALP=94, total protein=7.7, total Bili=1.0, Albumin=4.2, Hep A antibody reactive, other Hepatitis serology negative, anti-smooth muscle antibody negative, platelets=305, Ceruloplasmin=normal, ANA=negative, AFP=normal, A1A=negative.

Case 5. 52 year old male with decompensated congestive heart failure presents for evaluation of cardiac transplant workup. Lab tests as follows: AST = 66, ALT = 46, ALP = 1111, total bili = 3.1, total protein = 7./1, albumin = 2.7. The patient is critically ill in the ICU with cardiomyopathy and congestive heart failure. Eval liver for cardiac transplant workup. STAT. Please page Fellow Diego Belardi at 303-266-3620 with results. STAT.

Case 6. 45 y/o female with 8 year history of increasing LFT. Concern for cirrhosis on exam. Labs; AST=162, ALT=183, ALP=303, tbili=1.9, tprot=7.9, alb=3.3, HBV neg, HCV neg, AFP=10.3, pan-immunoglobulin elevation, ANA positive, ASMA neg, ceruloplasmin neg, A1A neg, PLAT=98. Clinical impression is advanced chronic liver disease due to autoimmune etiology.