“…Numerous studies have demonstrated that ALT is primarily enriched in liver tissue, while AST is widely distributed in diverse organs such as the brain, kidney, muscle, and even the heart. This could result in AST remaining in a higher proliferative state than ALT, even when the condition of the patient is deteriorating 11,15,16,24. Among patients with a poor outcome, the decrease in the ALT level was larger than that for AST, resulting in a higher AAR being related to a poor outcome.…”