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Background  Despite its established association with chronic kidney disease (CKD) the role of myosin-9 ( MYH9 ) gene variation on transplanted kidney function remains unknown. This study aimed at evaluating the effect of donor  MYH9  nephrogenic variants on renal allograft function within the first post transplantation year.    Methods  In the longitudinal kidney transplant study 207 deceased donors were genotyped for previously known risk  MYH9  single nucleotide polymorphisms (SNPs). The predictor was  MYH9  high–risk variants status. The primary outcome was mean eGFR found in low vs. high risk  MYH9  genotypes between third and twelfth post-transplant month, the secondary outcome was the risk of proteinuria.    Results  Distribution of genotypes remained in Hardy-Weinberg equilibrium. The T allele of rs3752462 (dominant model, TT or TC vs. CC) was associated with higher filtration rate ( P  = 0.05) in a multivariate analysis after adjusting for delayed graft function and donor sex. Two G alleles of rs136211 (recessive model, GG vs. GA or AA) resulted in doubling the risk of proteinuria (OR = 2.22; 95% CI = 1.18–4.37,  P  = 0.017) after adjusting for donor and recipient sex.    Conclusion  Deceased donor kidneys of European descent harboring  MYH9  SNPs rs3752462 T allele show significantly superior estimated filtration rate while those of rs136211 GG genotype excessive risk of proteinuria. These findings, if replicated, may further inform and improve individualization of allocation and treatment policies.

Effect of donor non-muscle myosin heavy chain (MYH9) gene polymorphisms on clinically relevant kidney allograft dysfunction