Single Gene Variant in Donors May Affect Survival of Transplanted Kidneys

According to a study in the Journal of the American Society of Nephrology (JASN), a single genetic variant in kidney donors' cells may help determine whether transplanted organs will survive long term. In the UK, Richard Burrows and his colleagues looked to see if variants in the genes that encode for the protein pumps influence the health of transplanted kidneys. This variant affects the protein, P-glycoprotein, expression encoded by the MDR-1 gene. The study, reported by Science Daily, provides new information that can be used to improve transplant longevity. This study reveals that the genetic make-up of kidney transplant donors affects the survival of transplanted organs. The study of donor, as opposed to recipient, is uncommon in the field of transplantation.

Although a kidney transplant can save a patient's life, the recipient is subjected to a life of taking drugs to suppress their immune system to prevent their body from rejecting the donated organ. Ironically, as stated by the article, the immunosuppressive drugs can cause kidney damage.

 

How well the proteins pump these drugs out of kidney cells may influence the drugs' kidney toxicity. To figure out the connection, Burrows and his colleagues investigated the links between donor and recipient gene variants with kidney outcome among 811 immunosuppressant treated kidney transplant recipients. The donors who had a variant within the multidrug resistance 1 (MDR-1) gene were linked to a 69% increased risk for long-term failure of transplanted organs. No other genetic variants were found to be linked to organ survival or failure. Looking at donors, as opposed to recipients, was a good idea. I found it strange that the immunosuppressant taken by kidney transplant recipients may lead to kidney damage. It sounds as if the patient could end up back at square one. Hopefully this study by JASN will lead to the elimination of immunosuppressive drugs for transplantation.

Cartoon depiction of the P-glycoprotein structure: