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African American living-kidney donors should be screened for APOL1 risk alleles

David M Cohen1, Anuja Mittalhenkle, David L Scott

  • 1Division of Nephrology and Hypertension, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA. cohend@ohsu.edu

Transplantation
|September 1, 2011
PubMed

Insights

African Americans face higher end-stage kidney disease (ESKD) rates and longer transplant waits. Screening for APOL1 risk alleles in living kidney donors could improve outcomes for this population.

Area of Science:

  • Nephrology
  • Genetics
  • Transplantation

Background:

  • African Americans experience disproportionately higher rates of end-stage kidney disease (ESKD) compared to European Americans.
  • This disparity leads to overrepresentation on kidney transplant waiting lists and extended wait times for African American patients.
  • Living donor transplantation is often recommended to mitigate these challenges.

Purpose of the Study:

  • To propose a screening strategy for APOL1 risk alleles in potential living kidney donors.
  • To address the genetic factors contributing to ESKD risk in African Americans.
  • To optimize kidney transplantation for African American recipients and their donors.

Main Methods:

  • Reviewing the genetic link between APOL1 risk alleles and ESKD.
  • Analyzing the prevalence of APOL1 risk alleles in African Americans.
  • Developing a proposed screening protocol for living kidney donors.

Main Results:

  • The APOL1 gene has been implicated in ESKD risk, particularly among African Americans.
  • Possessing two APOL1 risk alleles significantly doubles the relative risk for ESKD.
  • These risk alleles are common within the African American population.

Conclusions:

  • A targeted screening approach for APOL1 risk alleles is warranted.
  • Screening African American living kidney donors and living-related donors for African American recipients is proposed.
  • This strategy aims to improve kidney transplantation equity and outcomes.

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