If the transaminase value reaches more than 1000U/L, if it is caused by acute cholecystitis, cholangitis, etc., active treatment is expected to return to normal; if liver failure occurs, it may be life-threatening. 1. Acute cholecystitis: It is an inflammation of the gallbladder caused by obstruction of the gallbladder duct and bacterial attack, which can cause liver damage and abnormal elevation of transaminases. With active treatment of the primary disease and liver-protecting therapy, the transaminases may return to normal, and therefore will not lead to the patient’s death. 2. Cholangitis: it is usually due to the obstruction of stones in the bile ducts, which makes bile reflux and stagnation, and inflammation occurs, which damages the liver and raises the transaminases. Aggressive treatment is expected to return to normal. 3. Liver failure: usually occurs in the late stage of the development of cirrhosis, hepatitis B, etc. If the transaminase is elevated to more than 1,000U/L, and accompanied by reduced coagulation mechanism, such as prothrombin activity is less than 40%, it means that there is obvious damage to the liver cells. Liver failure may also present with a decrease in aminotransferases to the normal range, which needs to be analyzed in conjunction with other laboratory tests. Acute liver failure is a serious disease with rapid onset and progression, and complications such as hepatic encephalopathy and upper gastrointestinal hemorrhage can occur in a short period of time, rapidly leading to death. Transaminase 1000 should be timely medical treatment, to avoid the seriousness of the disease, affecting the life.