Transamination and Deamination

Which of the following is the primary cofactor required for transamination reactions catalyzed by aminotransferases?

A 38-year-old man from Mumbai presents to the emergency department with acute onset confusion, slurred speech, and a peculiar musty odor on his breath. His wife reports he has had progressive fatigue and loss of appetite for 3 weeks. On examination, he is jaundiced, with hepatomegaly and ascites. Laboratory investigations reveal: serum ammonia 180 µmol/L (normal: 15–45), ALT 320 U/L, AST 580 U/L, total bilirubin 4.2 mg/dL, and albumin 2.8 g/dL. Prothrombin time is prolonged. Which of the following best explains the elevated ammonia level in this patient?

Which enzyme catalyzes the oxidative deamination of glutamate, producing α-ketoglutarate and ammonia, and is unique in accepting multiple amino acids as substrates?