Analysis of pre-operative aspartate aminotransferase and alanine aminotransferase in 14,185 pediatric patients

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: The aim of this study was to investigate the efficacy of routine pre-anesthetic aspartate aminotransferase (AST) and alanine aminotransferase (ALT) tests for detection of hepatic abnormalities and usefulness in perioperative management. Methods: The laboratory findings of 14,185 pediatric patients younger than 18 years from October 2004 to December 2010 were investigated by retrospective review of medical records. All of the patients had undergone preoperative AST and ALT screening. Results: Among the 14,185 patients, 221 patients experienced elevation of both AST and ALT. However, only 21 patients were suspicious for hepatic disease defined as persistent elevation of AST and ALT preoperatively. Among the 221 patients with elevation of both AST and ALT, 20 patients were examined by additional abdominal ultrasonography and hepatic abnormalities were detected in 13 of these patients (65%) and 40 patients were consulted to the department of pediatrics or internal medicine. Conclusions: In this single-center, retrograde study, the usefulness of preoperative routine AST and ALT testing was shown to be limited for detection of hepatic abnormalities in pediatric patients undergoing general anesthesia. Further multi-center, large-scale investigation would be required. (Anesth Pain Med 2015; 10: 284-287)