Gilbert syndrome, a common genetic condition causing mild hyperbilirubinemia, is found to be a benign finding in liver transplant donors. A systematic review and meta-analysis confirms it does not compromise graft function or patient outcomes. The condition affects approximately 4% of liver donors and is typically asymptomatic.
Analyses of studies involving hundreds of donors and recipients revealed no significant differences in donor postoperative complications, recipient outcomes, or one-year survival rates between grafts from donors with and without Gilbert syndrome. While recipients of grafts from affected donors may show higher peak bilirubin levels post-surgery, this is not linked to impaired graft function.
Donor-derived Gilbert syndrome in recipients, observed in about half of cases from affected donors, also presents as benign unconjugated hyperbilirubinemia without adverse clinical effects or graft dysfunction. Overall postoperative complications were rare and not associated with graft failure or mortality.
The authors stress the importance of awareness of Gilbert syndrome for accurate interpretation of liver function tests and to reduce unnecessary investigations. These findings support the safety of liver transplantation with grafts from donors with Gilbert syndrome, potentially expanding the donor pool without compromising transplant safety.