Project Summary (Abstract) The Columbia-Penn Clinical Consortium (CPCC) brings together an experienced multidisciplinary team of clinical and basic scientist investigators at Columbia University Medical Center and University of Pennsylvania Transplant Programs. The CPCC investigators have expertise in the fields of transplant epidemiology, immunology, genetics and ethics, as well as an extensive history of collaboration with the United Network for Organ Sharing (UNOS) and other CPCC member transplant programs. As a result, the CPCC is well suited to recruit and retain patients for longitudinal follow up for the APOL1 Long-term Kidney Transplantation Outcomes Research Network (APOLLO). This proposed Clinical Center will comprise of 26 pediatric and adult large, medium and small size transplant centers and 9 organ procurement organizations predominantly in four contiguous states (NY, NJ, CT and PA) in the northeast US. Our primary objective is to enroll all donors of African ancestry (e.g. African-Americans and Black Hispanic) and their recipients within the consortium for genetic and genomic studies by the APOLLO Network (Aim 1). We will follow all recruited donor-recipient pairs with longitudinal collection of biospecimens and clinical outcomes along with pragmatic integration with Organ Procurement and Transplantation Network (OPTN), UNOS and the United States Renal Data System (USRDS) data (Aim 2). Our experience in the recruitment and retention of minority patients in multicenter studies, as well as the use of innovative analytics with linkage to UNOS, USRDS and other geospatial data, will be of benefit to the APOLLO Network. We expect that our unique design and implementation expertise to the APOLLO study will address the hypothesis that the presence of two APOL1 risk variants is associated with inferior allograft outcomes following kidney transplant and increases the risk of adverse renal outcomes for affected living donors.