Patients were censored at the date of the last follow-up, death, or liver retransplantation. The multivariate Cox proportional hazards regression analysis was used to evaluate the independence of the MBL2, FCN2, and MASP2 SNPs or the quantity of gene polymorphisms. The forced entry method, including all variables, as well as the backward elimination regression method (Wald statistic) was applied. Results were considered statistically significant

when P values were <0.05. Bonferroni correction for multiple comparison learn more tests was not performed because SNPs were selected on the basis of a deducible hypothesis. All analyses were performed with the SPSS statistical software package (version 16.02; SPSS, Inc., Chicago, IL). The principal study

consisted of 143 patients who received OLT (Table 1) of which 59 (41%) encountered a CSI within the Selleck Atezolizumab first year after transplantation. The MBL2, FCN2, and MASP2 genotype distribution of recipients and donors were analyzed in relation to the cumulative incidence of CSI in the first year after OLT (Supporting Table 2). Patients receiving a liver from an MBL-deficient donor (XA/O or O/O) had an increased cumulative incidence of CSI compared to those receiving a wild-type liver (Table 2). In addition, patients receiving a donor liver with at least one copy of the minor T-allele of FCN2 SNP rs17549193 (+6359CT) also had an increased cumulative CSI incidence. Interestingly, the absence of the minor C-allele (homozygosity for the major A-allele) of MASP2 SNP rs12711521 (+371AC) in the donor liver was also accompanied with an increased incidence

of CSI. The joint genetic effect of risk-conferring variants of MBL2, FCN2, and/or MASP2 present within the donor liver were clustered as the lectin pathway gene Galactosylceramidase profile (Table 2). This profile, including the number of risk-conferring gene variants, showed an ever-increasing cumulative risk for developing CSI with increasing numbers of variants: 18% CSI with no genetic variant, 33% in those with one, 50% in those with two, and 75% in those with three variants (P = 0.002; Table 2 and Fig. 1). The genotype distribution in OLT recipients (Supporting Table 2) showed no significant association with the occurrence of CSI either for the independent SNPs or for the number of risk-conferring variants (not shown). However, some remarkable interactions between the genotype of the donor and the recipient with the occurrence of CSI were found. Recipients with an MBL-sufficient or wild-type MBL genotype (A/A and YA/O) receiving an MBL-insufficient (XA/O and O/O) donor liver developed significantly more CSI than the other patients (61% [17/28] versus 37% [42/115], respectively, P < 0.006).