APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO): Design and Rationale

Barry I. Freedman, Marva M. Moxey-Mims, Amir A. Alexander, Brad C. Astor, Kelly A. Birdwell, Donald W. Bowden, Gordon Bowen, Jonathan Bromberg, Timothy E. Craven, Darshana M. Dadhania, Jasmin Divers, Mona D. Doshi, Elling Eidbo, Alessia Fornoni, Michael D. Gautreaux, Rasheed A. Gbadegesin, Patrick O. Gee, Giselle Guerra, Chi yuan Hsu, Ana S. IltisNichole Jefferson, Bruce A. Julian, David K. Klassen, Patrick P. Koty, Carl D. Langefeld, Krista L. Lentine, Lijun Ma, Roslyn B. Mannon, Madhav C. Menon, Sumit Mohan, J. Brian Moore, Barbara Murphy, Kenneth A. Newell, Jonah Odim, Mariella Ortigosa-Goggins, Nicholette D. Palmer, Meyeon Park, Afshin Parsa, Stephen O. Pastan, Emilio D. Poggio, Nishadi Rajapakse, Amber M. Reeves-Daniel, Sylvia E. Rosas, Laurie P. Russell, Deirdre Sawinski, S. Carrie Smith, Mitzie Spainhour, Robert J. Stratta, Matthew R. Weir, David M. Reboussin, Paul L. Kimmel, Daniel C. Brennan

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Introduction: Much of the higher risk for end-stage kidney disease (ESKD) in African American individuals relates to ancestry-specific variation in the apolipoprotein L1 gene (APOL1). Relative to kidneys from European American deceased-donors, kidneys from African American deceased-donors have shorter allograft survival and African American living-kidney donors more often develop ESKD. The National Institutes of Health (NIH)–sponsored APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO) is prospectively assessing kidney allograft survival from donors with recent African ancestry based on donor and recipient APOL1 genotypes. Methods: APOLLO will evaluate outcomes from 2614 deceased kidney donor-recipient pairs, as well as additional living-kidney donor-recipient pairs and unpaired deceased-donor kidneys. Results: The United Network for Organ Sharing (UNOS), Association of Organ Procurement Organizations, American Society of Transplantation, American Society for Histocompatibility and Immunogenetics, and nearly all U.S. kidney transplant programs, organ procurement organizations (OPOs), and histocompatibility laboratories are participating in this observational study. APOLLO employs a central institutional review board (cIRB) and maintains voluntary partnerships with OPOs and histocompatibility laboratories. A Community Advisory Council composed of African American individuals with a personal or family history of kidney disease has advised the NIH Project Office and Steering Committee since inception. UNOS is providing data for outcome analyses. Conclusion: This article describes unique aspects of the protocol, design, and performance of APOLLO. Results will guide use of APOL1 genotypic data to improve the assessment of quality in deceased-donor kidneys and could increase numbers of transplanted kidneys, reduce rates of discard, and improve the safety of living-kidney donation.

Original languageEnglish (US)
Pages (from-to)278-288
Number of pages11
JournalKidney International Reports
Volume5
Issue number3
DOIs
StatePublished - Mar 2020

Keywords

  • APOL1
  • African Americans
  • chronic kidney disease
  • graft failure
  • kidney transplantation
  • outcomes

ASJC Scopus subject areas

  • Ophthalmology
  • Nephrology

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    Freedman, B. I., Moxey-Mims, M. M., Alexander, A. A., Astor, B. C., Birdwell, K. A., Bowden, D. W., Bowen, G., Bromberg, J., Craven, T. E., Dadhania, D. M., Divers, J., Doshi, M. D., Eidbo, E., Fornoni, A., Gautreaux, M. D., Gbadegesin, R. A., Gee, P. O., Guerra, G., Hsu, C. Y., ... Brennan, D. C. (2020). APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO): Design and Rationale. Kidney International Reports, 5(3), 278-288. https://doi.org/10.1016/j.ekir.2019.11.022