For African-American Kidney Donors, Genetic Variants Linked to Graft Survival

Deceased-donor kidneys from African-Americans with two particular gene variants failed much more quickly than those from African-Americans without the two variants, found a single-center study published in the American Journal of Transplantation (2011;11:1025-1030). These results extend to transplantation the previously reported relationship between the apolipoprotein L1 (APOL1) gene and nondiabetic nephropathy risk in this population. “The APOL1 genetic association with nondiabetic kidney failure in African-Americans is among—if not the—most powerful genetic association in any common disease,” said senior author Barry I. Freedman, MD, Professor and Chief of the Section on Nephrology at Wake Forest School of Medicine, in a phone interview. “It fully explains the excess risk of nondiabetic kidney failure in blacks compared with whites in the United States and accounts for 40 percent or so of all African-Americans on dialysis. That’s very impressive, and there are no other genes in the renal literature of this effect. “If a kidney is donated by an African-American, it does not statistically function for as long as a kidney donated by a white, so one of the questions we had was, could this have anything to do with APOL1?” Finding this relationship between APOL1 risk variants in the donor and graft survival in the recipient could mean big changes for kidney transplantation, but not just yet. “These results have to be For African-American Kidney Donors, Genetic Variants Linked to Graft Survival