Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Dec 1;107(12):2575-2580.
doi: 10.1097/TP.0000000000004742. Epub 2023 Aug 1.

Association of Recipient APOL1 Kidney Risk Alleles With Kidney Transplant Outcomes

Neil Roy  1   2 , M Catalina Morales-Alvarez  1   2 , Karim H Anis  1   2 , Simin Goral  3 , Cataldo Doria  4 , Jeffrey B Kopp  5 , Cheryl A Winkler  6 , Rui Feng  7 , Sylvia E Rosas  1   2
Affiliations
Observational Study

Association of Recipient APOL1 Kidney Risk Alleles With Kidney Transplant Outcomes

Neil Roy et al. Transplantation. .

Abstract

Background: Kidney transplant survival in African American recipients is lower compared with non-African American transplant recipients. APOL1 risk alleles (RA) have been postulated as likely contributors. We examined the graft outcomes in kidney transplant recipients (KTRs) stratified by APOL1 RA status in a multicenter observational prospective study.

Methods: The Renal Transplant Outcome Study recruited a cohort of incident KTRs at 3 transplant centers in the Philadelphia area from 1999-2004. KTRs were genotyped for APOL1 RA. Allograft and patient survival rates were compared by the presence and number of APOL1 RA.

Results: Among 221 participants, approximately 43% carried 2 APOL1 RA. Recipients carrying 2 APOL1 RA demonstrated lower graft survival compared with recipients with only 1 or none of APOL1 RA at 1 y posttransplant, independently of other donor and recipient characteristics (adjusted hazard ratio 3.2 [95% confidence interval, 1.0-10.4], P = 0.05). There was no significant difference in overall survival or graft survival after 3 y posttransplantation. There was no difference in death by APOL1 -risk status ( P = 0.11).

Conclusions: Recipients with 2 APOL1 high-risk alleles exhibited lower graft survival 1 y posttransplantation compared with recipients with only 1 or 0 APOL1 RA. Further research is required to study the combined role of the recipient and donor APOL1 genotypes in kidney transplantation.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Kaplan-Meier survival estimates of graft survival stratified by APOL1 RA status throughout follow-up RA risk allele.
Figure 2.
Figure 2.
Directed acyclic graph of the association of recipient APOL1 RA status and graft failure. AKI, acute kidney injury; CKD, chronic kidney disease; CVD, cardiovascular disease; DM, diabetes mellitus; HTN, hypertension; RA, risk allele.
See this image and copyright information in PMC

References

    1. Feyssa E, Jones-Burton C, Ellison G, et al. Racial/ethnic disparity in kidney transplantation outcomes: influence of donor and recipient characteristics. J Natl Med Assoc. 2009;101:111–115. - PubMed
    1. Bekbolsynov D, Mierzejewska B, Khuder S, et al. Improving access to HLA-matched kidney transplants for African American patients. Front Immunol. 2022;13:832488. - PMC - PubMed
    1. Isaacs RB, Nock SL, Spencer CE, et al. Racial disparities in renal transplant outcomes. Am J Kidney Dis. 1999;34:706–712. - PubMed
    1. Ojo AO, Wolfe RA, Held PJ, et al. Delayed graft function: risk factors and implications for renal allograft survival. Transplantation. 1997;63:968–974. - PubMed
    1. Swanson SJ, Hypolite IO, Agodoa LY, et al. Effect of donor factors on early graft survival in adult cadaveric renal transplantation. Am J Transplant. 2002;2:68–75. - PubMed

Publication types