Incorporating apolipoprotein L1 testing into evaluation of potential living kidney donors: a single-centre experience

Assessment of Barriers to Donation for Potential Black Kidney Donors

“…In our practice, 7 out of 21 potential donors who had genetic testing were excluded due to the presence of high-risk APOL1 genotypes. In a UK cohort of 20 potential black donors, 30% were excluded due to the presence of high-risk APOL1 genotypes(7). Currently there is no consensus about screening for APOL1 genotypes in black potential kidney donors and 'The APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO) study (NCT03615235) findings are awaited; however, concerns about a more rapid fall in eGFR post-donation in donors with two APOL1 risk alleles(8) and worse outcomes for recipients of grafts for high-risk APOL1 donors (9) have led to many centres using APOL1 genotype testing as a routine investigation for black potential kidney donors (S2).Whilst education, including by peer educators, has been suggested as an approach to augment the number of black donors, immediate solutions to alter genetic and other medical factors which may prohibit donation are needed.…”

“…In a UK cohort of 20 potential Black donors, 30% were excluded due to the presence of high-risk APOL1 genotypes. 7 Currently there is no consensus about screening for APOL1 genotypes in Black potential kidney donors and The APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO) study (NCT03615235) findings are awaited; however, concerns about a more rapid fall in estimated glomerular filtration rate post-donation in donors with 2 APOL1 risk alleles 8 and worse outcomes for recipients of grafts for high-risk APOL1 donors 9 have led to many centers using APOL1 genotype testing as a routine investigation for Black potential kidney donors. S2…”