Abstract: SA-PO065
APOL1 Genotyping in Potential Kidney Donors of African Descent
Session Information
- Transplantation: Recipient and Donor Assessment
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1802 Transplantation: Clinical
Authors
- Tatapudi, Vasishta S., NYU Langone Health, New York, New York, United States
- Lonze, Bonnie E., NYU Langone Health, New York, New York, United States
- Ali, Nicole M., NYU Langone Health, New York, New York, United States
- Gelb, Bruce, NYU Langone Health, New York, New York, United States
- Montgomery, Robert Avery, NYU Langone Health, New York, New York, United States
Background
Inheritance of two APOL1 risk variants accounts for the excess risk of non-diabetic ESRD in African Americans when compared to Caucasian, Hispanic and Asian Americans. African American living donors have a higher risk of ESRD than matched non-black donors. APOL1 genotyping in potential kidney donors of African descent may identify individuals at risk for progressive CKD following donation.
Methods
We report the retrospective analysis of APOL1 genotyping in a cohort of African American potential kidney donors. In July 2016, we initiated targeted genotyping of all African American kidney donor candidates. African American candidates with two APOL1 risk variants were excluded from kidney donation.
Results
A total of 28 African American kidney donor candidates were evaluated between July 2016 and April 2018. 2 (7%) were found to have two APOL1 risk variants (high risk genotype). Low risk genotype was identified in 10 (36%) candidates who had one risk variant and 16 (57%) candidates who had none. To date, 15 candidates have completed their donor work-up. Of these, 7 (47%) have already undergone donor nephrectomy, and 4 (27%) were cleared for surgery and are awaiting operation. 4 (27%) of the candidates did not meet our center specific criteria for donation. 2 out these 4 candidates who were excluded from donation were ruled out expressly for having been found to have two APOL1 risk variants.
Conclusion
APOL1 genotyping led to the exclusion of two donors who might have previously been allowed to donate, possibly mitigating their risk of CKD/ESRD and suboptimal graft outcomes in recipients.
Baseline characteristics of potential kidney donors
| APOL1 High risk genotype Mean ± SD | APOL1 Low risk Genotype Mean ± SD | p-value | |
| Age (years) | 40.5 ± 6.3 | 36 ± 10.2 | 0.52 |
| Gender – Male: n (%) | 13 (50%) | 0 (0%) | not calculated |
| BMI (kg/m2) | 32.4 ± 2.5 | 27.2 ± 4.2 | 0.23 |
| Creatinine (mg/dL) | 0.8 ± 0.002 | 0.9 ± 0.026 | 0.09 |
| Systolic BP mm Hg | 118 ± 11.3 | 115 ± 7.9 | 0.78 |
| Diastolic BP mm Hg | 73 ± 7.1 | 70.9 ± 9.3 | 0.76 |
| MDRD eGFR (ml/min/1.733m2) | 101.5 ± 10.6 | 106.9 ± 19.8 | 0.76 |