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Apolipoprotein L1 Gene Effects on Kidney Transplantation
Barry I Freedman1, Jayme E Locke2, Amber M Reeves-Daniel1
1Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
Seminars in Nephrology
|November 8, 2017
Summary
Genetic variations in the apolipoprotein L1 gene (APOL1) explain ethnic disparities in chronic kidney disease risk. APOL1 risk variants impact kidney transplant survival and donor selection, advancing precision medicine in nephrology.
Area of Science:
- Nephrology
- Genetics
- Transplantation
Background:
- Recent molecular genetic advances illuminate nephropathy pathogenesis.
- Ethnic disparities in non-diabetic chronic kidney disease risk between African Americans and European Americans are largely due to apolipoprotein L1 gene (APOL1) variations.
- Two APOL1 renal risk variants significantly elevate kidney disease risk.
Purpose of the Study:
- To review existing data on APOL1 in kidney transplantation.
- To consider the impact of APOL1 genotyping on deceased-donor kidney allocation and discard.
- To examine APOL1's role in living-donor selection.
Main Methods:
- Review of existing literature on APOL1 in kidney transplantation.
- Analysis of APOL1 genotyping data in donor selection and kidney survival.
Main Results:
- Kidneys from deceased African American donors with two APOL1 risk variants show reduced survival post-transplantation, irrespective of recipient ethnicity.
- APOL1 genotyping is crucial for understanding transplant outcomes.
Conclusions:
- APOL1 variations are key to understanding kidney disease disparities and transplant outcomes.
- Precision medicine, incorporating APOL1 genotyping, will transform nephrology and kidney transplantation practices.
- APOL1 testing will be vital for kidney donor allocation and recipient selection, particularly for individuals with African ancestry.
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