Apolipoprotein L1 Opinions of African American Living Kidney Donors, Kidney Transplant Patients, and Nonpatients.
Apolipoprotein L1 Opinions of African American Living Kidney Donors, Kidney Transplant Patients, and Nonpatients.
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非裔美国活体肾脏捐赠者、肾移植患者和非患者对载脂蛋白 L1 的看法。
DOI：
10.1016/j.jss.2022.04.011
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Rodrigue,JamesR
中科院分区：
文献类型：
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作者：
Harris,DwightD;Fleishman,Aaron;Pavlakis,Martha;Pollak,MartinR;Baliga,PrabhakarK;Rohan,Vinayak;Kayler,LiiseK;Rodrigue,JamesR
载脂蛋白L1（ApoL1）的发现，提出了重要的伦理和临床问题的背景下，活着的和去世的肾脏捐赠的基因检测。从这次讨论中缺失的是那些非洲裔美国人（AA）的观点最有可能受到影响的ApoL1 testing.MethodsWe调查了331 AA潜在的和前活体肾供体（LKD），肾移植候选人和受体，以及非患者在三个美国移植程序对他们的ApoL1测试态度。72%的人认为移植计划应该为AA潜在LKD提供ApoL1检测。如果潜在的LKD具有高风险基因型，79%的人认为应该允许LKD做出自己的捐赠决定或与移植医生共同参与决策。超过一半的潜在LKD（58%）将接受ApoL1测试，81%的前LKD现在将接受测试。大多数移植候选人表示接受肾脏从LKD（79%）或已故捐助者（67%）与高风险genotype.ConclusionsThere是强有力的支持LKD和移植患者之间的ApoL1测试时，评估潜在的肾脏捐助者的非洲血统。在制定ApoL1检测指南和教育计划时，将AA利益相关者纳入其中至关重要。
IntroductionThe discovery of apolipoprotein L1 (ApoL1) has raised important ethical and clinical questions about genetic testing in the context of living and deceased kidney donation. Largely missing from this discussion are the perspectives of those African Americans (AA) most likely to be impacted by ApoL1 testing.MethodsWe surveyed 331 AA potential and former living kidney donors (LKDs), kidney transplant candidates and recipients, and nonpatients at three United States transplant programs about their ApoL1 testing attitudes.ResultsOverall, 72% felt that transplant programs should offer ApoL1 testing to AA potential LKDs. If a potential LKD has the high-risk genotype, 79% felt that the LKD should be allowed to make their own donation decision or participate in shared decision-making with transplant doctors. More than half of the potential LKDs (58%) would undergo ApoL1 testing and 81% of former LKDs would take the test now if offered. Most transplant candidates expressed a low likelihood of accepting a kidney from a LKD (79%) or a deceased donor (67%) with the high-risk genotype.ConclusionsThere is strong support among LKDs and transplant patients for ApoL1 testing when evaluating potential kidney donors of African ancestry. Inclusion of AA stakeholders in developing guidelines and educational programs for ApoL1 testing is critical.