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Effect of Replacing Race With Apolipoprotein L1 Genotype in Calculation of Kidney Donor Risk Index.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2017 Jun; Vol. 17 (6), pp. 1540-1548. Date of Electronic Publication: 2017 Jan 03. - Publication Year :
- 2017
-
Abstract
- Renal allografts from deceased African American donors with two apolipoprotein L1 gene (APOL1) renal-risk variants fail sooner than kidneys from donors with fewer variants. The Kidney Donor Risk Index (KDRI) was developed to evaluate organ offers by predicting allograft longevity and includes African American race as a risk factor. Substituting APOL1 genotype for race may refine the KDRI. For 622 deceased African American kidney donors, we applied a 10-fold cross-validation approach to estimate contribution of APOL1 variants to a revised KDRI. Cross-validation was repeated 10 000 times to generate distribution of effect size associated with APOL1 genotype. Average effect size was used to derive the revised KDRI weighting. Mean current-KDRI score for all donors was 1.4930 versus mean revised-KDRI score 1.2518 for 529 donors with no or one variant and 1.8527 for 93 donors with two variants. Original and revised KDRIs had comparable survival prediction errors after transplantation, but the spread in Kidney Donor Profile Index based on presence or absence of two APOL1 variants was 37 percentage points. Replacing donor race with APOL1 genotype in KDRI better defines risk associated with kidneys transplanted from deceased African American donors, substantially improves KDRI score for 85-90% of kidneys offered, and enhances the link between donor quality and recipient need.<br /> (© 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Adolescent
Adult
Cohort Studies
Female
Follow-Up Studies
Genotype
Graft Rejection epidemiology
Graft Rejection genetics
Graft Survival
Humans
Incidence
Male
Middle Aged
Prognosis
Risk Factors
Survival Rate
United States epidemiology
Young Adult
Apolipoprotein L1 genetics
Biomarkers metabolism
Genetic Variation
Graft Rejection mortality
Kidney Transplantation mortality
Racial Groups genetics
Tissue Donors
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 17
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 27862962
- Full Text :
- https://doi.org/10.1111/ajt.14113