Clinical Lab Handbook

Container/Tube: SST

Alternate Container: Lithium Heparin (Mint), Red top

Specimen Volume: 5 mL of serum

Collection Instructions: Allow blood to clot for 30 minutes. Spin tube after the 30 minute interval.

Special Handling Information: Centrifuge specimens and remove the serum or plasma from the cellular material within 3 days of collection.

The VITROS ALTV Slide is a multilayered, analytical element coated on a polyester support. A drop of patient sample is deposited on the slide and is evenly distributed by the spreading layer to the underlying layers. The spreading layer contains the ALT substrates L-alanine and sodium α-ketoglutarate. Alanine aminotransferase catalyzes the transfer of the amino group of L-alanine to α-ketoglutarate in the presence of pyridoxyl-5-phosphate (P-5-P) to produce pyruvate and glutamate. Pyruvate is oxidized to acetylphosphate and hydrogen peroxide by pyruvate oxidase. The final reaction step involves the peroxidase-catalyzed oxidation of a leuco dye to produce a colored dye. The rate of oxidation of the leuco dye is monitored by reflectance spectrophotometry. The rate of change in reflectance density is proportional to enzyme activity in the sample. The low wavelength cutoff filter on the slide support minimizes the blank rate effects of incident light during the dye development.

Alanine aminotransferase (ALT), an enzyme involved in amino acid metabolism, is found in many tissues, such as the liver, cardiac and skeletal muscle, kidneys, and pancreas. Therefore, ALT elevations are found associated with both hepatic and non-hepatic disorders e.g. hepatitis, cirrhosis, liver tumors, biliary obstruction, Reye’s syndrome, rhabdomyolysis, myositis, myocarditis, and myocardial infarction. Due to its primarily liver distribution, ALT elevations are highly suggestive of liver damage and ALT measurements are particularly useful in the diagnosis and management of liver disease.

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