Abstract
common. There was no relationship with causes of BCS or with the number of thrombosed hepatic veins. ALT decreased in all patients before any treatment was performed. In patients with high, but rapidly decreasing ALT (50% decrease within 3 days), factor V level rapidly increased. No death occurred in this group (median follow-up of 78 months), whereas 2 out of 8 patients with high ALT that decreased slowly died within 3 months. Survival without liver transplantation was significantly worst in patients with high ALT than in others (5-year survival: 45 vs 68%; p = 0.003). However, ALT level did not add information to that of available prognostic scores. Conclusion: ALT level at diagnosis allows for distinguishing 2 variants of BCS. High ALT levels reflect severe, but potentially reversible, ischemic hepatic cell necrosis. High ALT level associated with acute hepatic dysfunction, should not be the sole basis for making a decision for urgent recanalization or liver transplantation. The initial course of these anomalies should also be taken into consideration.
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