DJS is an autosomal recessive disorder that causes an increase in conjugated
bilirubin without elevation of liver
enzymes. Most patients are asymptomatic and have normal life spans, but to the best of our knowledge, their livers have never been reported to be grafts in
liver transplantation. Herein, we report an infant patient with MMA that received a partial liver graft from his mother, who had DJS. A biliary anastomosis
stricture was noted five months after
transplantation and was successfully treated with radiological interventions. Otherwise, the patient's liver functions were normal, and a liver biopsy showed a pathognomonic picture of DJS nine months after the
transplantation. The patient was followed for one yr, and the results were satisfactory for an increase in oral intake and
protein uptake, no recurrence of metabolic
stroke and there was a gradual catch-up with regard to physical development despite having a persistently abnormal profile of
amino acid analysis. From the experience of our case, we suggest that a liver from a donor with DJS can be used as a graft for
liver transplantation, although long-term follow-up is mandatory to examine the grafted liver under the use of immunosuppressive medications.