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Donor mannose‐binding lectin gene polymorphisms influence the outcome of liver transplantation
Author(s) -
Cervera Carlos,
Balderramo Domingo,
Suárez Belén,
Prieto Jhon,
Fuster Francisco,
Linares Laura,
Fuster Josep,
Moreno Asunción,
Lozano Francisco,
Navasa Miquel
Publication year - 2009
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21834
Subject(s) - mannan binding lectin , liver transplantation , genotype , medicine , exon , immunology , hazard ratio , transplantation , gastroenterology , liver disease , confidence interval , biology , gene , lectin , genetics
Mannose‐binding lectin (MBL) is a C‐type lectin produced mainly by the liver that binds to a wide range of pathogens. Polymorphisms at the promoter and exon 1 of the MBL2 gene are responsible for low serum levels of MBL and have been associated with an increased risk of infections. We prospectively analyzed 95 liver transplant recipients. Well‐known functionally relevant polymorphisms of the MBL2 gene of the liver donor were examined by gene sequencing. Infectious events were collected prospectively. No differences in the incidence of infections were found according to the donor MBL2 genotypes. Survival was lower in patients receiving a liver graft from a donor with an exon 1 MBL2 variant genotype, and they had higher infection‐related mortality (50% versus 14%, P = 0.040). No differences were found according to other polymorphisms involving the promoter and 5′‐untranslated region. When we analyzed bacterial infection episodes, we found that patients receiving a liver from a donor with an exon 1 variant genotype had a higher incidence of septic shock (46% versus 11%, P = 0.004). Independent variables associated with graft or patient survival were as follows: receiving a graft from a donor with an exon 1 MBL2 variant genotype [adjusted hazard ratio (aHR), 9.64; 95% confidence interval (CI), 2.59‐36.0], the Model for End‐Stage Liver Disease score (aHR, 1.14; 95% CI, 1.05‐1.23), and bacterial infections (aHR, 11.1; 95% CI, 2.73‐44.9). Liver transplantation from a donor with a variant MBL2 exon 1 genotype was associated with a worse prognosis, mainly because of infections of higher severity. Liver Transpl 15:1217–1224, 2009. © 2009 AASLD.