APOL1 Genotype and Kidney Transplantation Outcomes From Deceased African American Donors.
Published
Journal Article
BACKGROUND: Two apolipoprotein L1 gene (APOL1) renal-risk variants in donors and African American (AA) recipient race are associated with worse allograft survival in deceased-donor kidney transplantation (DDKT) from AA donors. To detect other factors impacting allograft survival from deceased AA kidney donors, APOL1 renal-risk variants were genotyped in additional AA kidney donors. METHODS: The APOL1 genotypes were linked to outcomes in 478 newly analyzed DDKTs in the Scientific Registry of Transplant Recipients. Multivariate analyses accounting for recipient age, sex, race, panel-reactive antibody level, HLA match, cold ischemia time, donor age, and expanded criteria donation were performed. These 478 transplantations and 675 DDKTs from a prior report were jointly analyzed. RESULTS: Fully adjusted analyses limited to the new 478 DDKTs replicated shorter renal allograft survival in recipients of APOL1 2-renal-risk-variant kidneys (hazard ratio [HR], 2.00; P = 0.03). Combined analysis of 1153 DDKTs from AA donors revealed donor APOL1 high-risk genotype (HR, 2.05; P = 3 × 10), older donor age (HR, 1.18; P = 0.05), and younger recipient age (HR, 0.70; P = 0.001) adversely impacted allograft survival. Although prolonged allograft survival was seen in many recipients of APOL1 2-renal-risk-variant kidneys, follow-up serum creatinine concentrations were higher than that in recipients of 0/1 APOL1 renal-risk-variant kidneys. A competing risk analysis revealed that APOL1 impacted renal allograft survival, but not recipient survival. Interactions between donor age and APOL1 genotype on renal allograft survival were nonsignificant. CONCLUSIONS: Shorter renal allograft survival is reproducibly observed after DDKT from APOL1 2-renal-risk-variant donors. Younger recipient age and older donor age have independent adverse effects on renal allograft survival.
Full Text
Duke Authors
Cited Authors
- Freedman, BI; Pastan, SO; Israni, AK; Schladt, D; Julian, BA; Gautreaux, MD; Hauptfeld, V; Bray, RA; Gebel, HM; Kirk, AD; Gaston, RS; Rogers, J; Farney, AC; Orlando, G; Stratta, RJ; Mohan, S; Ma, L; Langefeld, CD; Bowden, DW; Hicks, PJ; Palmer, ND; Palanisamy, A; Reeves-Daniel, AM; Brown, WM; Divers, J
Published Date
- January 2016
Published In
Volume / Issue
- 100 / 1
Start / End Page
- 194 - 202
PubMed ID
- 26566060
Pubmed Central ID
- 26566060
Electronic International Standard Serial Number (EISSN)
- 1534-6080
Digital Object Identifier (DOI)
- 10.1097/TP.0000000000000969
Language
- eng
Conference Location
- United States