WINSTON-SALEM, N.C. – Sept. 22, 2017 – The National Institutes of Health (NIH) has
awarded two five-year grants to Wake Forest Baptist Medical Center worth more
than $5 million to prospectively study the effects of a genetic variation in
organ donors that appears to contribute to survival of kidneys after
will establish the APOL1 Long-term Transplantation Outcomes Network (APOLLO) to
evaluate donor and recipient apolipoprotein L1 (APOL1) renal-risk variants in
all U.S. kidney transplants from African-American kidney donors to determine
their effect on transplant outcomes. In addition, the post-donation health and
kidney function of African-American living kidney donors will be assessed.
from deceased African-American donors fail more rapidly compared to kidneys
transplanted from deceased European- American donors. Reasons for this are
unknown, but retrospective studies suggest that the presence of two APOL1 renal-risk variants in the African-American kidney
donors may contribute to the disparity.
These gene variants
are common in populations with recent African ancestry, such as African-Americans, where they are strongly associated with non-diabetic end-stage
kidney disease, but rare in other racial or ethnic groups. Up to 40 percent of
end-stage kidney disease in African Americans is related to variation in this
data may provide physicians with a more accurate way to assess the
likelihood for long-term renal function in transplanted kidneys,” said nephrologist Barry I.
Freedman, M.D., John H. Felts,III, Distinguished Professor of Internal Medicine, at Wake Forest Baptist and a
principal investigator at the Wake Forest Baptist APOLLO coordinating center.
“Hopefully, it also will improve our ability to match donor kidneys with potential
recipients to improve the success rate of kidney transplants and patient
As the national coordinating center for the APOLLO
consortium, Wake Forest Baptist will be closely aligned with the United Network
of Organ Sharing, the Association of Organ Procurement Organizations and 13
APOLLO clinical trial centers. Co-principal investigators of the APOLLO
coordinating center are David Reboussin, Ph.D., Robert Stratta, M.D., and
Donald Bowden, Ph.D., of Wake Forest Baptist.
Pioneering studies led by Freedman demonstrated that two
copies of the APOL1 gene in African-American kidney donors were associated with
more rapid failure of transplanted kidneys.
In addition, the NIH funding supports an APOLLO clinical center
led by Amber Reeves-Daniel, D.O., of Wake Forest Baptist, and Rasheed
Gbadegesin, M.D., of Duke University Medical Center. This clinical trial site,
with its 12 counterparts around the country, will assist in developing the
protocol and recruiting participants for APOLLO.
“Findings from the APOLLO study have the potential to
alter clinical practice by increasing the numbers of kidneys available for
transplantation and improving matching of kidneys with recipients to extend
post-transplant kidney function,” Freedman said.
Other academic medical centers participating in the Wake Forest
Baptist Collaborative APOLLO Clinical Center include the University of North
Carolina at Chapel Hill, East Carolina University, Virginia Commonwealth University,
University of Illinois Chicago, Albert Einstein College of Medicine and
Northwestern University Feinberg School of Medicine.