PROJECT SUMMARY 12/14 APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO) Clinical Center We submit this application in response to RFA-DK-22-506. UCSF is a current member of the APOLLO Consortium. This Consortium was established in 2017 to work seamlessly with the Association of Organ Procurement Organizations (AOPO) to enroll participants in the largest observational study to date of kidney transplant recipients and donors to evaluate APOL1 gene mutations as a risk factor for graft loss. Our Clinical Center has been a leader on the West Coast, collaborating with our sites at University of California Los Angeles, University of California Davis (UC Davis), California Pacific Medical Center (CPMC), Stanford University, and University of Southern California. In Phase 1 or APOLLO, we have successfully enrolled a total of 223 participants across these centers, with DNA specimens in hand for 221/223. Our site has overseen the careful collection of clinical data from the electronic medical record at our own site and those of our engaged centers to complete the APOLLO Consortium Data forms accurately and completely. In Phase 2, we will continue to obtain critical follow-up data on all participants and ensure completion of data abstraction from electronic medical record continues at our engaged sites, to provide patient-level detail not available in databases maintained by United Network for Organ Sharing (UNOS) and the Scientific Registry of Transplant Recipients (SRTR). We will ensure a urine albumin-to-creatinine ratio is measured in all participants, at all sites, at a longitudinal follow-up time point at least two years after transplantation in APOLLO Phase 1. We will collect additional biospecimens for contribution to the biorespository as well as unstained biopsy slides as we have been doing through Phase 1. We will work with the Scientific Data and Coordinating Center to ensure return of genotype results to all study participants who desire this information. We will also continue to recruit living donors at our site. Continuation of the APOLLO Consortium will lead to important advances in our understanding of APOL1 high-risk status and its influence on graft function as well as the biology of APOL1 gene effects.