Wake ForestWhat really leads some kidneys to perform better than others post a transplant? That’s precisely what a fresh study by scientists at Wake Forest Baptist Medical Center intends looking at. The investigation offers to allow doctors to screen for donor kidneys more effectively, allowing the selection of those having higher chances of survival.

Medical records going back to 1998 was used by the scientists. This 12 years’ worth of medical data analyzed patients who had been administered a kidney transplant from a black donor who was deceased. The donor’s genetic details were reportedly on record. For a total of 136 kidneys that were donated, the search resulted in 106 black donors. Transplantation of either one or both kidneys had occurred.

“It’s been long observed that kidneys taken from some black donors just don’t last as long as those taken from non-black donors, and the reason for that has not been known. This study reveals that the genetic profile of the donor has a marked affect on graft survival after transplantation. We now know that these organs aren’t failing because they came from black donors, but rather because they came from individuals with two copies of a specific recessive gene,” shared Barry I. Freedman, M.D., John H. Felts III Professor and senior investigator.

It was observed that kidneys obtained from donors who showed particular coding changes in the apolipoprotein L1 (APOL1) gene did not survive long post transplant when pitted against donors minus these alterations. Apparently, the coding modifications in the APOL1 gene had the ability to affect the function of kidney transplant in about 10 to 12 percent of black individuals.

More recently, the studies by Freedman and colleagues reveal that it is these genetic alterations which are linked to higher chances of kidney disease. It was this that actually jolted scientists to comprehend the part played by these changes as far as transplant success is concerned.

“In looking at the records and follow-up of the recipients of these organs, we accounted for all the usual factors that are known to contribute to more rapid loss of kidney function after transplant,” eluciated Freedman, chief of the section on nephrology. “What we found was that the kidney disease-causing risk variants in APOL1 were the strongest predictor of graft loss after transplant. The effect of having two copies of this gene was stronger than the impact of genetic matching between donor and recipient, the amount of time the organ was out of the body, and the antibody levels. APOL1 dwarfed all these other factors known to affect survival.”

Needing confirmation by other investigators, the analysis seemingly has the ability to significantly better the outcomes of kidney transplants. This applies both to those undergoing transplantation and those considering being a kidney donor. What’s more, it could reform the criteria of donor selection. It will empower physicians to spot kidneys that have a higher likelihood to function only for a short span. There’s also the added perk of being able to safeguard potential donors at danger of developing kidney disease in the long run.

The study appears in the May issue of the American Journal of Transplantation.