PGAP3 and biosynthetic process: Similarly, patients in the Transamidase+Remodeling Group, predominantly patients with PGAP3 mutations, are significantly more likely to having Macrotia. The Transamidase+Remodeling Group patients were classified as having Macrotia (large ears greater than 2x the standard deviation) 25% of the time, while the incidence was only 2% for the Synthesis Group patients.