It's in the Genes, Not the Skin

Genetics predict kidney transplant failure

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Doctors have noticed that kidneys taken from some African-American donors for transplant don't last as long as kidneys from other donors. However, race may not have much to do with the failure of these organs.

Rather, a certain gene may be causing these kidney transplants to fail.

Researchers found that certain kidneys are not lasting long because of the donors' genetics. It just so happens that 10 to 12 percent of black people have the genetic code that has been linked to the failure of donated kidneys.

"Genetics, not race, affect whether a donated kidney survives."

Before this study, researchers did not know why kidneys from black donors were not lasting. Now, they have found that donor kidneys may be failing because the donor has two copies of a certain gene.

These genetic changes have been linked to an increased risk of kidney disease.

According to Barry I. Freedman, M.D., from Wake Forest Baptist Medical Center, if these findings are confirmed by other researchers, it will allow doctors to screen for kidneys that may not last long. It will also let doctors help potential donors who are at risk of kidney disease.

These findings could dramatically change how kidney donor selection is done, Freedman concludes.

"There are currently more than 88,000 people awaiting a kidney transplant in this country, and more than 30,000 are African-American," says Michelle Segovia of the Texas Organ Sharing Alliance. "In 2010, only 1,323 organ donors were African-American."

"Transplants are usually more successful if the donor and the recipient share genetic similarities which are found in our certain ethnic groups," Segovia continues. "Therefore, it stands to reason if more minorities donate, more minorities will receive the transplants they need. Please register to save lives through organ donation at"

The Study

  • Freedman and colleagues looked at 12 years of medical records, searching for all patients who received a kidney transplant from a black, dead donor whose genetic information had been recorded
  • The researchers found 106 donors that matched the criteria, for a total of 136 donated kidneys
  • Donated kidneys did not last long if the donor had certain coding changes in a gene called apolipoprotein L1 (APOL1)
  • Having two copies of APOL1 was the strongest predictor of losing a donated kidney
  • These coding changes are found in 10 to 12 percent of black individuals
Reviewed by: 
Review Date: 
May 10, 2011
Last Updated:
May 11, 2011