This article shows that serum alanine aminotransferase (ALT) doesn't reliably predict the degree of liver damage in many cases, and a person can have significant liver damage and have a "normal" serum ALT level. The serum ALT is only one blood test that doctors use to test people for evidence of liver damage, but it is a commonly-used one. The authors of this article talk about the way the normal range of ALT values was established 40 years ago, and other aspects of the test make it insensitive as a way of "checking" for liver damage, due to various causes, in many cases:
http://www.ncbi.nlm.nih.gov/pubmed/12774006
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