Aminotransferases over 1000 can be potentially fatal in certain extreme cases. The normal value for transaminases is usually no more than 40, so when transaminase values reach more than 1000, they are already more than 20 times the normal value, indicating that there is significant liver cell damage and possibly even extensive liver cell necrosis. This can cause acute liver failure if the ability of liver cells to regenerate and repair is exceeded. Acute liver failure is a very serious disease that not only has a rapid onset, but also progresses rapidly and can lead to serious complications such as hepatic encephalopathy and upper gastrointestinal bleeding in a short period of time, rapidly leading to death. Even if there are no serious complications, the mortality rate of patients is very high if they are not given treatment with artificial liver or even liver transplantation. However, transaminases reaching over 1000 do not necessarily mean that the condition is very serious. Some patients with acute cholecystitis and cholangitis may also have significantly elevated transaminases, even reaching 1000 or more. However, with timely control of inflammation and liver preservation treatment, the transaminases may quickly return to normal, not only without serious complications, but also without causing death.