Donor and Recipient APOL1/MYH9 Risk Alleles Are not Associated with Risk for Kidney Allograft Loss
Bibliographic record
Abstract
Introduction: African Americans have a 4-fold higher risk of kidney disease than European Americans, likely accounted for in large part by MYH9 and APOL1 genetic variants. Genetic screening of African Americans has been suggested in kidney transplantation to improve outcomes for donors and recipients. Methods: To determine the risk of kidney allograft failure associated with MYH9 and APOL1 risk variants, African American deceased or live kidney transplant donors and recipients from kidney transplantations performed between April 10, 1995 and December 14, 2009 were studied. Donor and recipient DNA was genotyped for four MYH9 (E1 haplotype) and three APOL1 (G1,G2 haplotypes) single nucleotide polymorphisms (SNP). Results: After excluding patients receiving incompatible kidney transplants, those with failed DNA amplification, and allograft failure within 30 days of transplantation, the final study population included 205 unique donors with 215 recipients. MYH9 and APOL1 risk alleles were more frequent in recipients versus donors. Twenty five kidney allografts failed (17 from live donors; 8 from deceased donors) with a mean of 4.65 years of follow-up. Neither recipient nor donor MYH9 and APOL1 risk alleles was associated with allograft failure in proportional hazards models adjusting for age, gender, and donor-recipient relatedness (Table). Similar results were noted for carriers of two APOL1 risk alleles.Table: [Relative Hazard for Allograft Failure (95% CI)]Conclusion: These negative findings emphasize the limitations of genetic screening in kidney donor and recipient evaluations. Integration of genetic screening into practice should be limited until larger studies demonstrate that genetic information has clinical utility in predicting outcomes among African Americans.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".