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

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    Author
    Freedman, B.I.
    Bromberg, J.
    Weir, M.R.
    Date
    2020
    Journal
    Kidney International Reports
    Publisher
    Elsevier Inc
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.ekir.2019.11.022
    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.
    Sponsors
    Support was received from the following National Institutes of Health grants. APOLLO is registered in clinicaltrials.gov as NCT03615235
    Keyword
    African Americans
    APOL1
    chronic kidney disease
    graft failure
    kidney transplantation
    outcomes
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85078860388&doi=10.1016%2fj.ekir.2019.11.022&partnerID=40&md5=2ed3e3f83dc05b0883d5a2cc86e1ad12; http://hdl.handle.net/10713/11985
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ekir.2019.11.022
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