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Background  Apolipoprotein L1 gene ( APOL1 ) G1 and G2 renal-risk variants, common in populations with recent African ancestry, are strongly associated with non-diabetic nephropathy, end-stage kidney disease, and shorter allograft survival in deceased-donor kidneys (autosomal recessive inheritance). Circulating APOL1 protein is synthesized primarily in the liver and hydrodynamic gene delivery of  APOL1  G1 and G2 risk variants has caused hepatic necrosis in a murine model.    Methods  To evaluate the impact of these variants in liver transplantation, this multicenter study investigated the association of  APOL1  G1 and G2 alleles in deceased African American liver donors with allograft survival. Transplant recipients were followed for liver allograft survival using data from the Scientific Registry of Transplant Recipients.    Results  Of the 639 liver donors evaluated, 247 had no  APOL1  risk allele, 300 had 1 risk allele, and 92 had 2 risk alleles. Graft failure assessed at 15 days, 6 months, 1 year and total was not significantly associated with donor  APOL1  genotype (p-values = 0.25, 0.19, 0.67 and 0.89, respectively).    Conclusions  In contrast to kidney transplantation, deceased-donor  APOL1  G1 and G2 risk variants do not significantly impact outcomes in liver transplantation.

Deceased-Donor Apolipoprotein L1 Renal-Risk Variants Have Minimal Effects on Liver Transplant Outcomes