Opinions of African American adults about the use of apolipoprotein L1 (ApoL1) genetic testing in living kidney donation and transplantation.

Opinions of African American adults about the use of apolipoprotein L1 (ApoL1) genetic testing in living kidney donation and transplantation.
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DOI:
10.1111/ajt.16206
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发表时间:
2021-03
期刊:
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子:
--
通讯作者:
Rodrigue JR
Rodrigue JR
中科院分区:
其他
文献类型:
--
作者:
Berrigan M;Austrie J;Fleishman A;Tercyak KP;Pollak MR;Pavlakis M;Rohan V;Baliga PK;Kayler LK;Feeley TH;Rodrigue JR

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载脂蛋白L1(ApoL1)预测肾脏疾病的基因检测及其在移植中的新作用仍然存在争议,因为它可能会加剧风险增加的非洲裔美国人(AAs)之间的潜在差异。我们进行了一个在线模拟AAs(N=585)对ApoL1检测及其辅助因子的兴趣,在两种情况下:作为一个潜在的活体供者(PLD),并作为一个等待移植的患者。大多数受访者(61%)表示对基因检测作为PLD的高度兴趣:年龄≥35岁(aOR:1.75,CI:1.18,2.60,P =0.01),AA身份(aOR:1.67,CI:1.02,2.72,P =0.04),自觉肾脏疾病风险对ApoL1测试感兴趣(aOR:1.68,CI:1.03,2.73,P =0.03)、对遗传学感兴趣(aOR:2.89,CI:1.95,4.29,P =0.001)和遗传学自我效能感(aOR:2.38,CI:1.54,3.67,P =0.001)与ApoL1测试感正相关。如果等待移植,大多数(89%)认为ApoL1检测应在AA死亡供体中进行,年龄较大(aOR:1.85,CI:1.03,3.32,P =0.04)和对遗传学更感兴趣(aOR:2.61,CI:1.41,4.81,P =0.002)与检测死亡供体的兴趣相关。研究结果强调了对AAs中ApoL1检测的强有力支持,以及在PLD和移植患者中检查此类意见以加强患者教育工作的必要性。
Apolipoprotein L1 (ApoL1) predictive genetic testing for kidney disease, and its emerging role in transplantation, remains controversial as it may exacerbate underlying disparities among African Americans (AAs) at increased risk. We conducted an online simulation among AAs (N=585) about interest in ApoL1 testing and its cofactors, under two scenarios: as a potential living donor (PLD), and as a patient awaiting transplantation. Most respondents (61%) expressed high interest in genetic testing as a PLD: age ≥35 years (aOR: 1.75, CI: 1.18,2.60, P=0.01), AA identity (aOR: 1.67, CI:1.02,2.72, P=0.04), perceived kidney disease risk following donation (aOR: 1.68, CI: 1.03,2.73, P=0.03), interest in genetics (aOR: 2.89, CI: 1.95,4.29, P=0.001), and genetics self-efficacy (aOR: 2.38, CI: 1.54,3.67, P=0.001) were positively associated with ApoL1 test interest. If awaiting transplantation, most (89%) believed that ApoL1 testing should be done on AA deceased donors, and older age (aOR: 1.85, CI: 1.03,3.32, P=0.04) and greater interest in genetics (aOR: 2.61, CI: 1.41,4.81, P=0.002) were associated with interest in testing deceased donors. Findings highlight strong support for ApoL1 testing in AAs and the need to examine such opinions among PLDs and transplant patients to enhance patient education efforts.
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