Liver transplantation using donors with Gilbert syndrome.

Serum bilirubin level is an essential factor included in the first step in evaluating living liver donor candidates. Our evaluation strategy was examined in living donors with possible Gilbert's syndrome (GS). When donor candidates had hyperbilirubinemia (>1.5 mg/dl), but otherwise normal liver function tests, their genomic DNA was isolated from leukocytes. They were diagnosed with GS when they had mutations of uridine diphosphate glucuronosyltransferase 1 typical to GS. The donors and recipients were divided into two groups: GS donors and their recipients (n = 6, each) and non-GS donors and their recipients (n = 65). All GS donors and their recipients had an unremarkable postoperative course. Total bilirubin levels of the recipients of GS donors were higher than those of recipients of non-GS donors. Living donor liver transplantation is safe for both donors with GS and their recipients.