Apolipoprotein L1 Gene Variants in Deceased Organ Donors Are Associated With Renal Allograft Failure. Issue 6 (24th March 2015)

• Record Type: Journal Article
• Authors: Freedman, B. I.; Julian, B. A.; Pastan, S. O.; Israni, A. K.; Schladt, D.; Gautreaux, M. D.; Hauptfeld, V.; Bray, R. A.; Gebel, H. M.; Kirk, A. D.; Gaston, R. S.; Rogers, J.; Farney, A. C.; Orlando, G.; Stratta, R. J.; Mohan, S.; Ma, L.; Langefeld, C. D.; Hicks, P. J.; Palmer, N. D.; Adams, P. L.; Palanisamy, A.; Reeves‐Daniel, A. M.; Divers, J.
• Is Part Of: American journal of transplantation. Volume 15:Issue 6(2015:Jun.)
• Page Start: 1615
• Page End: 1622
• Publication Date: 2015-03-24
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.13223
• Languages: English
• ISSNs: 1600-6135

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ajt13223-sec-0001" sec-type="section"> <p>Apolipoprotein L1 gene (<italic>APOL1</italic>) nephropathy variants in African American deceased kidney donors were associated with shorter renal allograft survival in a prior single‐center report. <italic>APOL1</italic> G1 and G2 variants were genotyped in newly accrued DNA samples from African American deceased donors of kidneys recovered and/or transplanted in Alabama and North Carolina. <italic>APOL1</italic> genotypes and allograft outcomes in subsequent transplants from 55 U.S. centers were linked, adjusting for age, sex and race/ethnicity of recipients, HLA match, cold ischemia time, panel reactive antibody levels, and donor type. For 221 transplantations from kidneys recovered in Alabama, there was a statistical trend toward shorter allograft survival in recipients of two‐<italic>APOL1</italic>‐nephropathy‐variant kidneys (hazard ratio [HR] 2.71; p = 0.06). For all 675 kidneys transplanted from donors at both centers, <italic>APOL1</italic> genotype (HR 2.26; p = 0.001) and African American recipient race/ethnicity (HR 1.60; p = 0.03) were associated with allograft failure. Kidneys from African American deceased donors with two <italic>APOL1</italic> nephropathy variants reproducibly associate with higher risk for allograft failure after transplantation. These findings warrant consideration of rapidly genotyping deceased African American kidney donors for <italic>APOL1</italic> risk variants at organ recovery and incorporation of results into allocation and informed‐consent processes.</p> </sec> </abstract>