Elevated ALT - 2 months post kasai - Children's Liver ...

Children's Liver Disease Foundation

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Elevated ALT - 2 months post kasai


Hi all,

My daughter has biliary atresia. Kasai done when she's 4 weeks old. Bilirubin went down since kasai but never below 20 (last 3 weeks is 26 - 23 - 24) but her ALT has been showing a trend of increase since a month ago. Latest ALT is 219.

Dr said, if it is around 75-lower100 we don't need to worry. But if it is higher100 ++ there might be some attack to the liver.

Has anyone experienced this?

Note: my baby is currently 3 months old and a happy chatty girl. Stool still has good colour and she has no fever.

Geeess.. Blood tests makes me worry all the time

12 Replies

Hi, our daughter had the kasai over 12 months ago. I remember her bilirubin dropping straight after surgery but ALT AST and GGT continued to go up (ggt was thousands) for weeks/months following surgery. The surgeon explained to us that it was to be expected (to a certain degree) as the surgery itself is a pretty major insult to the liver - they shave part of it and then attach a bowel-pipe!). My understanding was that liver enzymes can take longer to go back to normal - providing they do. Even with good bile drainage a biliary atresia liver is scarred and normal LFTs are a rarity. Cholangitis complicates matters - but if there's no fever and normal stool colour then it doesn't sound the case! Good luck x

4rie in reply to Widemoon

Hi, thank you for your reply. Is it normal for bilirubin and LFT to be up and down too? I read somewhere / someone told me that even teething can make bilirubin rise a bit. Have you ever heard of that?

Widemoon in reply to 4rie

From what I know a lot of things can alter bilirubin - fasting, infections, etc. Never heard of teething/growth spurts as a cause but I guess it could be! It's hard to be sure as these kids are tested regularly unlike other kids, so I don't actually know what normal LFTs are for a child that is having chickenpox for ex. I guess we have to take into consideration the context, and in kids with liver disease first thing to rule out is primary liver issue - in these cases there would be a trend of deterioration over time.

From our experience LFTs can defo go up and down especially in the first few wks/months after kasai. We have too been obsessed with blood results from the start, we have them all and there has definitely always been an irregular trend for a while. I'd check with your baby's consultant at next clinic or even before, it's good to have all questions and doubts answered!

Bayu in reply to Widemoon

Hello can I know how old is your child now, and also what is the latest ggt level so that I have an idea

Widemoon in reply to Bayu

Not relevant to post kasai now, as she has had a transplant. I don't think her levels right now would be much help and indication for a post kasai comparison! She is however 18 months old.

Bayu in reply to Widemoon

God bless your child.. My prayers for her good health

it took some time for my sons labs to come back down after the kasai

Bayu in reply to Mothercrunchy

God bless your child. How old is he now and how often do you get the blood tests done what's the latest values.. Please let me know so that Im aware of it

Hi God bless your child,my baby had her Kasai when she was 55days old. She is 2 now. We got her left done in Feb this year liver enzymes results take long time to come down her results is still elevated and on still udcament medication. We should just keep a tab on the child's growth,fever and stool. And lfts please don't ignore that's how we get to know how the liver is functioning do not neglect what your consultant says. Followups must. I am also praying to God that my daughter should be hale and healthy. I know how it feels when your child is not well, but please have faith in God you will overcome all the obstacles..

After I joined this group have started praying for all of you

God bless all!!

4rie in reply to Bayu

Hi bayu, is your kid bilirubin level normal now?

Bayu in reply to 4rie

Hi yes billirubin is fine but alt ggt is on higher side doc says it's fine but we might have to get a transplant later after few years.. I am still praying to God for her good health


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