Introduction: Genetic polymorphisms of Apolipoprotein 1 (ApoL1) and non-muscle heavy chain 9 (MYH9) genes are known to be strongly associated with focal segmental glomerulosclerosis, HIV-associated nephropathy, non-diabetic end stage kidney disease (ESKD) or hypertension-attributed ESKD. For the kidney transplant recipients, the increased risk of allograft loss was suggested from the African American donors with the ApoL1 variation, but the impact of recipient's variations of ApoL1 or MYH9 is still controversial and mixed depending on the ethnicity and location.

Research Question or Hypothesis: To determine the prevalence and influence of ApoL1 and MYH9 genetic polymorphisms among the Hispanic kidney allograft recipients in Los Angeles area.

Study Design: A total of 304 renal transplant patients between 2008 and 2012 at St. Vincent Medical Center, CA were investigated in a retrospective study design, which include 177 Hispanics, 26 African Americans and others.

Methods: Single nucleotide polymorphisms of ApoL1 and MYH9 were determined by the real time PCR. Tested genetic polymorphisms of ApoL1 include two-allele haplotype termed “G1” and “G2”. For MYH9, four genetic polymorphisms (rs4821480, rs2032487, rs4821481, rs3752462) were tested.

Results: Among the 177 Hispanic kidney transplant patients, 6.2% had more than 1 risky ApoL1 haplotypes while 80.8% of the African American recipients had more than 1 risky ApoL1 haplotypes. The reasons for ESKD of the Hispanic patients who carried risky haplotypes were mostly hypertension or diabetes (81.8%). Among the Hispanic patients with risky haplotypes, 81.8% experienced > 500 mg proteinuria (OR=4.5, CI 0.943-21.483, p=0.059) while it was 52.4% for the African American patients. For the MYH9 polymorphisms, 6.3% of Hispanic kidney transplant recipients carried risky alleles, which were lower than African Americans (19.2%) or White populations (12%).

Conclusions: The incidence of risky ApoL1 haplotypes among the Hispanic kidney transplant recipients was higher than the previously reported incidences among the ESKD population. However, reasons for the ESKD were still mostly hypertension or diabetes. In our study, risky ApoL1 haplotypes were marginally associated with increased risk of proteinuria among the Hispanic kidney transplant recipients.

CITATION INFORMATION: Chang Y, Shah T, Min D. Analysis of ApoL1 and MYH9 Genetic Polymorphisms Among the Hispanic Kidney Allograft Recipients. Am J Transplant. 2017;17 (suppl 3).

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