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Effect of apolipoprotein E polymorphism on renal transplantation
1Renal Transplant Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. fcofan@clinic.ub.es
Transplantation Proceedings
|September 25, 2007
Summary
The apolipoprotein E (apoE) E4 allele negatively impacts long-term patient and graft survival in kidney transplant recipients, especially those over 60. This genetic factor increases risks for graft loss and death, with cardiovascular causes prevalent in E4 carriers.
Area of Science:
- Nephrology
- Genetics
- Cardiovascular Medicine
Background:
- Dyslipidemia is a key cardiovascular risk factor and contributes to chronic graft failure in kidney transplant recipients.
- Apolipoprotein E (apoE), crucial for lipid metabolism, is linked to hypercholesterolemia and early coronary disease.
Purpose of the Study:
- To investigate the influence of apolipoprotein E (apoE) gene polymorphism on the long-term outcomes of renal transplant recipients.
Main Methods:
- Genomic DNA from 517 renal transplant recipients (5.4-year follow-up) was analyzed for apoE (E2, E3, E4) alleles using PCR.
- Univariate and Cox multivariate regression models assessed donor-recipient variables and their association with patient and graft survival.
Main Results:
- The E4 allele was significantly associated with an increased independent risk of graft loss (OR 3.23) and patient death (OR 16.03), particularly in recipients over 60 years old.
- In E4 allele carriers over 60, graft loss and death risks were elevated, with 45% of deaths attributed to cardiovascular causes.
- Specific genotypes (E2/E4, E3/E4, E4/E4) correlated with poorer patient survival in univariate analysis.
Conclusions:
- Apolipoprotein E (apoE) E4 allele polymorphism independently and negatively affects long-term patient and graft survival in kidney transplant recipients.
- The adverse impact of the apoE E4 allele is particularly pronounced in older transplant recipients (>60 years).
- This genetic predisposition highlights the importance of considering apoE genotype in managing cardiovascular risk and optimizing long-term outcomes post-transplantation.
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