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  1. Article ; Online: Recipient APOL1 Genotype Effects on Outcomes After Kidney Transplantation.

    Freedman, Barry I / Mena-Gutierrez, Alejandra M / Ma, Lijun

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2021  Volume 79, Issue 3, Page(s) 450–452

    MeSH term(s) Apolipoprotein L1/genetics ; Genotype ; Graft Survival/genetics ; Humans ; Kidney Transplantation
    Chemical Substances APOL1 protein, human ; Apolipoprotein L1
    Language English
    Publishing date 2021-11-18
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2021.11.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1669: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 468: Show issues

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  2. Article ; Online: Practical Considerations for APOL1 Genotyping in the Living Kidney Donor Evaluation.

    Mena-Gutierrez, Alejandra M / Reeves-Daniel, Amber M / Jay, Colleen L / Freedman, Barry I

    Transplantation

    2019  Volume 104, Issue 1, Page(s) 27–32

    Abstract: Background: Association between the apolipoprotein L1 gene (APOL1) and nephropathy has altered the epidemiology of chronic kidney disease. In addition, donor APOL1 genotypes play important roles in the time to allograft failure in kidneys transplanted ... ...

    Abstract Background: Association between the apolipoprotein L1 gene (APOL1) and nephropathy has altered the epidemiology of chronic kidney disease. In addition, donor APOL1 genotypes play important roles in the time to allograft failure in kidneys transplanted from deceased donors and the safety of living kidney donation.
    Methods: This article reviews genetic testing for inherited kidney disease in living kidney donors to improve donor safety. APOL1 genotyping in donors with recent African ancestry is considered.
    Results: Based on current data, transplant physicians should discuss APOL1 genotyping with potential living kidney donors self-reporting recent African ancestry. Until results from APOL1 Long-term Kidney Transplant Outcomes Network ancillary studies are available, we present practical approaches from our experience for considering APOL1 genotyping in the living donor evaluation.
    Conclusions: Transplant physicians should inform potential living kidney donors at risk for APOL1-associated nephropathy about the gene and possibility of genetic testing early in the donor evaluation, well before scheduling the donor nephrectomy. Transplant programs must weigh risks of performing a donor nephrectomy in those with 2 APOL1 renal risk variants (high-risk genotypes), particularly younger individuals. Our program counsels kidney donors with APOL1 high-risk genotypes in the same fashion as with risk genotypes in other nephropathy genes. Because most African American kidney donor candidates lacking hypertension, proteinuria and reduced kidney function after workup will not possess APOL1 high-risk genotypes, genetic testing is unlikely to markedly increase donor declines and may reassure donors with regard to their long-term kidney outcomes, potentially increasing the number of African American donors.
    MeSH term(s) African Continental Ancestry Group/genetics ; Apolipoprotein L1/genetics ; Donor Selection/standards ; Genetic Predisposition to Disease ; Genetic Testing/standards ; Humans ; Kidney Transplantation/standards ; Living Donors ; Nephrectomy/adverse effects ; Patient Safety ; Postoperative Complications/prevention & control ; Practice Guidelines as Topic ; Renal Insufficiency, Chronic/congenital ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Tissue and Organ Harvesting/adverse effects ; Transplantation, Homologous/standards
    Chemical Substances APOL1 protein, human ; Apolipoprotein L1
    Language English
    Publishing date 2019-08-25
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000002933
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 488: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 509: Show issues

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  3. Article ; Online: Employment status at transplant influences ethnic disparities in outcomes after deceased donor kidney transplantation.

    Divers, Jasmin / Mohan, Sumit / Brown, W Mark / Pastan, Stephen O / Israni, Ajay K / Gaston, Robert S / Bray, Robert / Islam, Shahidul / Sakhovskaya, Natalia V / Mena-Gutierrez, Alejandra M / Reeves-Daniel, Amber M / Julian, Bruce A / Freedman, Barry I

    BMC nephrology

    2022  Volume 23, Issue 1, Page(s) 6

    Abstract: Background: African American (AA) recipients of deceased-donor (DD) kidney transplants (KT) have shorter allograft survival than recipients of other ethnic groups. Reasons for this disparity encompass complex interactions between donors and recipients ... ...

    Abstract Background: African American (AA) recipients of deceased-donor (DD) kidney transplants (KT) have shorter allograft survival than recipients of other ethnic groups. Reasons for this disparity encompass complex interactions between donors and recipients characteristics.
    Methods: Outcomes from 3872 AA and 19,719 European American (EA) DDs who had one kidney transplanted in an AA recipient and one in an EA recipient were analyzed. Four donor/recipient pair groups (DRP) were studied, AA/AA, AA/EA, EA/AA, and EA/EA. Survival random forests and Cox proportional hazard models were fitted to rank and evaluate modifying effects of DRP on variables associated with allograft survival. These analyses sought to identify factors contributing to the observed disparities in transplant outcomes among AA and EA DDKT recipients.
    Results: Transplant era, discharge serum creatinine, delayed graft function, and DRP were among the top predictors of allograft survival and mortality among DDKT recipients. Interaction effects between DRP with the kidney donor risk index and transplant era showed significant improvement in allograft survival over time in EA recipients. However, AA recipients appeared to have similar or poorer outcomes for DDKT performed after 2010 versus before 2001; allograft survival hazard ratios (95% CI) were 1.15 (0.74, 1.76) and 1.07 (0.8, 1.45) for AA/AA and EA/AA, compared to 0.62 (0.54, 0.71) and 0.5 (0.41, 0.62) for EA/EA and AA/EA DRP, respectively. Recipient mortality improved over time among all DRP, except unemployed AA/AAs. Relative to DDKT performed pre-2001, employed AA/AAs had HR = 0.37 (0.2, 0.69) versus 0.59 (0.31, 1.11) for unemployed AA/AA after 2010.
    Conclusion: Relative to DDKT performed before 2001, similar or worse overall DCAS was observed among AA/AAs, while EA/EAs experienced considerable improvement regardless of employment status, KDRI, and EPTS. AA recipients of an AA DDKT, especially if unemployed, had worse allograft survival and mortality and did not appear to benefit from advances in care over the past 20 years.
    MeSH term(s) Adult ; African Americans/psychology ; Employment ; Female ; Graft Survival ; Humans ; Kidney Failure, Chronic/ethnology ; Kidney Failure, Chronic/mortality ; Kidney Failure, Chronic/surgery ; Kidney Transplantation ; Male ; Middle Aged ; Proportional Hazards Models ; Race Factors ; Tissue Donors ; Transplantation, Homologous ; United States/epidemiology
    Language English
    Publishing date 2022-01-03
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-021-02631-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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