# APOL1 and Kidney Transplantation Outcomes Vanderbilt Clinical Center

> **NIH NIH U01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $306,448

## Abstract

An excess burden of chronic kidney and end stage renal disease is born by African Americans. Risk
variants in the apolipoprotein-1 (APOL1) gene, found almost exclusively in individuals of African ancestry, are
associated with several forms of non-diabetic kidney disease in African Americans, including focal segmental
glomerulosclerosis, HIV-associated nephropathy, and hypertension-related kidney disease. These APOL1 risk
variants explain up to 70% of the excess risk in African Americans developing these kidney diseases.
However, presence of these risk variants does not guarantee development of kidney disease, with secondary
genetic or environmental hits required. This along with lack of targeted therapies makes the value of genetic
screening for APOL1 risk variants unknown. The impact of APOL1 risk variants in kidney transplantation, for
both donors and recipients, is understudied. Kidney transplantation is the preferred treatment for end stage
renal disease, affording significant survival, quality of life, and health economic advantages over chronic
dialysis. It is unknown if living kidney donors with APOL1 risk variants are at increased risk for development of
kidney disease post donation. For recipients, initial studies have suggested that recipients who receive donor
kidneys with two APOL1 risk variants may have worse graft outcomes. Due to both biological and social-
economic factors, African Americans have been historically disadvantaged in receiving kidney transplants, and
the theoretical practice of APOL1 genetic screening and excluding donors with risk variants could further
disadvantage this population. These multiple questions highlight the need to thoroughly examine the impact of
APOL1 risk alleles on transplant outcomes. The NIH- sponsored APOL1 Long-term Kidney Transplantation
Outcomes Network (APOLLO) will address this important question by uniting transplant centers, organ
procurement organizations (OPOs), and the United Network for Organ Sharing (UNOS) to enroll these donors
and follow transplant outcomes. We propose to be an ideal clinical center in direct response to this request for
application by accomplishing several aims. In Aim 1, we will recruit and retain 200 donor-recipient kidney
transplant pairs for APOL1 genetic testing where donors are African American or mixed African ancestry and
perform longitudinal clinical follow up of living donors and recipients to better understand the impact APOL1
donor status has on transplant outcomes. In Aim 2, we will further enrich the APOLLO objectives by
meaningfully engaging patients through assessing local attitudes, priorities, and preferences regarding
participant recruitment and APOL1 genetic testing using the novel method of Community Engagement Studios.
This method is effective in recruitment and retention of minority participants. In Aim 3, we will determine
genomic “second hits” using advanced genomic analyses to determine what additional genetic variation
beyond APOL1 genot...

## Key facts

- **NIH application ID:** 10213705
- **Project number:** 5U01DK116093-05
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Kelly A Birdwell
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $306,448
- **Award type:** 5
- **Project period:** 2017-09-25 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10213705

## Citation

> US National Institutes of Health, RePORTER application 10213705, APOL1 and Kidney Transplantation Outcomes Vanderbilt Clinical Center (5U01DK116093-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10213705. Licensed CC0.

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