Kidney International Reports (Mar 2020)
APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO): Design and Rationale
- Barry I. Freedman,
- Marva M. Moxey-Mims,
- Amir A. Alexander,
- Brad C. Astor,
- Kelly A. Birdwell,
- Donald W. Bowden,
- Gordon Bowen,
- Jonathan Bromberg,
- Timothy E. Craven,
- Darshana M. Dadhania,
- Jasmin Divers,
- Mona D. Doshi,
- Elling Eidbo,
- Alessia Fornoni,
- Michael D. Gautreaux,
- Rasheed A. Gbadegesin,
- Patrick O. Gee,
- Giselle Guerra,
- Chi-yuan Hsu,
- Ana S. Iltis,
- Nichole Jefferson,
- Bruce A. Julian,
- David K. Klassen,
- Patrick P. Koty,
- Carl D. Langefeld,
- Krista L. Lentine,
- Lijun Ma,
- Roslyn B. Mannon,
- Madhav C. Menon,
- Sumit Mohan,
- J. Brian Moore,
- Barbara Murphy,
- Kenneth A. Newell,
- Jonah Odim,
- Mariella Ortigosa-Goggins,
- Nicholette D. Palmer,
- Meyeon Park,
- Afshin Parsa,
- Stephen O. Pastan,
- Emilio D. Poggio,
- Nishadi Rajapakse,
- Amber M. Reeves-Daniel,
- Sylvia E. Rosas,
- Laurie P. Russell,
- Deirdre Sawinski,
- S. Carrie Smith,
- Mitzie Spainhour,
- Robert J. Stratta,
- Matthew R. Weir,
- David M. Reboussin,
- Paul L. Kimmel,
- Daniel C. Brennan
Affiliations
- Barry I. Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Correspondence: Barry I. Freedman, Section on Nephrology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157–1053, USA.
- Marva M. Moxey-Mims
- Division of Nephrology, Children's National Health System, Washington, DC, USA
- Amir A. Alexander
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Brad C. Astor
- Department of Medicine, Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Kelly A. Birdwell
- Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University, Nashville, Tennessee, USA
- Donald W. Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Gordon Bowen
- Lifebanc, Cleveland, Ohio, USA
- Jonathan Bromberg
- Department of Surgery, Division of Transplantation, University of Maryland School of Medicine, Baltimore, Maryland, USA; Department of Microbiology and Immunology, Division of Transplantation, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Timothy E. Craven
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Darshana M. Dadhania
- Division of Nephrology, Weill Cornell Medicine, New York, New York, USA; Department of Transplantation Medicine, New York Presbyterian Hospital, New York, New York, USA
- Jasmin Divers
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Mona D. Doshi
- Division of Nephrology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Elling Eidbo
- Association of Organ Procurement Organizations, Vienna, Virginia, USA
- Alessia Fornoni
- Katz Family Division of Nephrology and Hypertension, Peggy and Harold Katz Drug Discovery Center, University of Miami Miller School of Medicine, Miami, Florida, USA
- Michael D. Gautreaux
- Human Leukocyte Antigen/Immunogenetics and Immunodiagnostics Laboratories, Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Rasheed A. Gbadegesin
- Department of Pediatrics, Division of Nephrology, Duke University School of Medicine, Durham, North Carolina, USA
- Patrick O. Gee
- APOLLO Community Advisory Council, Cleveland Clinic, Cleveland, Ohio, USA
- Giselle Guerra
- Katz Family Division of Nephrology and Hypertension, Peggy and Harold Katz Drug Discovery Center, University of Miami Miller School of Medicine, Miami, Florida, USA; Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Chi-yuan Hsu
- Department of Medicine, Division of Nephrology, University of California, San Francisco, San Francisco, California, USA
- Ana S. Iltis
- Center for Bioethics, Health and Society, Department of Philosophy, Wake Forest University, Winston-Salem, North Carolina, USA
- Nichole Jefferson
- APOLLO Steering Committee, APOLLO Community Advisory Council, Dallas, Texas, USA
- Bruce A. Julian
- Department of Medicine, Division of Nephrology, University of Alabama School of Medicine in Birmingham, Birmingham, Alabama, USA
- David K. Klassen
- United Network for Organ Sharing, Office of the Chief Medical Officer, Richmond, Virginia, USA
- Patrick P. Koty
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Carl D. Langefeld
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Krista L. Lentine
- Department of Medicine, Center for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, Missouri, USA
- Lijun Ma
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Roslyn B. Mannon
- Department of Medicine, Division of Nephrology, University of Alabama School of Medicine in Birmingham, Birmingham, Alabama, USA
- Madhav C. Menon
- Department of Nephrology, Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Recanati-Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Sumit Mohan
- Division of Nephrology, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- J. Brian Moore
- Institutional Review Board, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Barbara Murphy
- Department of Nephrology, Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Recanati-Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Kenneth A. Newell
- Department of Surgery, Division of Transplantation, Emory University School of Medicine, Atlanta, Georgia, USA
- Jonah Odim
- Transplantation Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Mariella Ortigosa-Goggins
- Katz Family Division of Nephrology and Hypertension, Peggy and Harold Katz Drug Discovery Center, University of Miami Miller School of Medicine, Miami, Florida, USA; Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Nicholette D. Palmer
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Meyeon Park
- Department of Medicine, Division of Nephrology, University of California, San Francisco, San Francisco, California, USA
- Afshin Parsa
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
- Stephen O. Pastan
- Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA
- Emilio D. Poggio
- Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Nishadi Rajapakse
- National Institutes of Health, National Institute on Minority Health and Health Disparities, Division of Scientific Programs, Bethesda, Maryland, USA
- Amber M. Reeves-Daniel
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Sylvia E. Rosas
- Kidney and Hypertension Unit, Joslin Diabetes Center and Harvard Medical School, Boston, Massachusetts, USA; Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Laurie P. Russell
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Deirdre Sawinski
- Renal Electrolyte and Hypertension Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- S. Carrie Smith
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Mitzie Spainhour
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Robert J. Stratta
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Matthew R. Weir
- Department of Medicine, Division of Nephrology, University of Maryland School of Medicine, Baltimore, Maryland, USA
- David M. Reboussin
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Paul L. Kimmel
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
- Daniel C. Brennan
- Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Journal volume & issue
-
Vol. 5,
no. 3
pp. 278 – 288
Abstract
Introduction: Much of the higher risk for end-stage kidney disease (ESKD) in African American individuals relates to ancestry-specific variation in the apolipoprotein L1 gene (APOL1). Relative to kidneys from European American deceased-donors, kidneys from African American deceased-donors have shorter allograft survival and African American living-kidney donors more often develop ESKD. The National Institutes of Health (NIH)–sponsored APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO) is prospectively assessing kidney allograft survival from donors with recent African ancestry based on donor and recipient APOL1 genotypes. Methods: APOLLO will evaluate outcomes from 2614 deceased kidney donor-recipient pairs, as well as additional living-kidney donor-recipient pairs and unpaired deceased-donor kidneys. Results: The United Network for Organ Sharing (UNOS), Association of Organ Procurement Organizations, American Society of Transplantation, American Society for Histocompatibility and Immunogenetics, and nearly all U.S. kidney transplant programs, organ procurement organizations (OPOs), and histocompatibility laboratories are participating in this observational study. APOLLO employs a central institutional review board (cIRB) and maintains voluntary partnerships with OPOs and histocompatibility laboratories. A Community Advisory Council composed of African American individuals with a personal or family history of kidney disease has advised the NIH Project Office and Steering Committee since inception. UNOS is providing data for outcome analyses. Conclusion: This article describes unique aspects of the protocol, design, and performance of APOLLO. Results will guide use of APOL1 genotypic data to improve the assessment of quality in deceased-donor kidneys and could increase numbers of transplanted kidneys, reduce rates of discard, and improve the safety of living-kidney donation. Keywords: African Americans, APOL1, chronic kidney disease, graft failure, kidney transplantation, outcomes
