Genes, not race, determine donor kidney survival

Donated kidneys from black donors do not last as long as those from non-black donors, and new research from Wake Forest Baptist Medical Center shows why.

The same gene that causes kidneys to stop functioning in blacks is now found to be responsible for the failure of kidney transplants from black donors. The organs are not failing simply because of the donors’ race, but because those individuals have differences in a specific gene: APOL1, says Dr. Barry I. Freedman, senior investigator on the project.

The APOL1 gene is found in one out of 10 African-Americans. Kidney experts believe these altered genes became common in Africa because they protected people from a parasite infection called African Sleeping Sickness.

Africans without this altered gene died, leaving behind a population of Africans who continued to pass on the gene.

Researchers reviewed transplant records since 1998, looking for all patients who received a kidney transplant from a deceased black donor, collecting data on 136 kidneys.

“We have shown for the first time that genetic risk variants in kidney donors are associated with markedly different outcomes after kidney transplantation,” said Freedman. “This finding could dramatically change the way we practice.”

Researchers are hopeful that this study can provide transplant doctors with a better way to screen for kidneys that have the best chance of survival.

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