We assessed the clinical relevance of elevated AST or ALT levels using four liver failure criteria-two for acute liver failure, and two that determine prognosis from chronic liver disease. The American Association for the Study of Liver Diseases (AASLD) recommends defining acute liver failure in a patient as: international normalized ratio (INR)$1.5, any degree of altered mental status, and illness ,26 weeks in duration without preexisting cirrhosis [15] . The King's College criteria assess prognoses in those with acute liver failure; the criteria are: prothrombin time .100 seconds or 3 of the following: age .40 years, prothrombin time .50 seconds, serum bilirubin .18 mg/dL, time from jaundice to encephalopathy .7 days [16] . The model for endstage liver disease (MELD) determines three-month mortality based on the following formula: 3.86(log serum bilirubin [mg/ dL])+11.26(log INR)+9.66(log serum creatinine [mg/dL])+6.4 [17] . The Child-Pugh criteria include assessment of degree of ascites, serum bilirubin and albumin, prothrombin time, and encephalopathy to determine one-and two-year survival [18] .