A case of living donor with Gilbert's syndrome and constitutional indocyanine green excretory defect

Abstract

An indocyanine green (ICG) test is a reliable and convenient examination that has been generally used for evaluating the liver function for hepatectomy, especially in patients with hepatic cirrhosis. We routinely perform an ICG test a preoperative examination for the donor of the living donor liver transplantation (LDLT). Here we report a rare case of living donor with Gilbert's syndrome and a constitutional ICG excretory defect.A 32-year-old woman became a donor candidate of LDLT for her 7-month-old nephew with fulminant hepatic failure. Preoperative examination tests showed no abnormal values except a marked delay of ICG retention rate at 15 minutes (69.2%) and hyperbilirubinemia; total bilirubin was 2.5 mg/dl, and indirect bilirubin was 2.3 mg/dl. The patient was diagnosed as Gilbert's syndrome with constitutional ICG excretory defect but was still entitled as an appropriate living donor. Left lateral segmentectomy was performed for the donor, and there were neither perioperative nor postoperative complications. Laboratory tests of the donor showed no remarkable change during a two-year course after surgery. The recipient was discharged 87 days after the transplantation without severe complications.This case report showed that left lateral segmentectomy could safely be performed on the living donor with Gilbert's syndrome and constitutional ICG excretory defect. However, more data collections and deliberations are required to decide whether a volume extraction of grafts, i.e., right or left lobe, is applicable to this donor.