Evidence map›Paper›PMID 40498120›Full record

ArticleBundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz2025

Contextual factors of implementing APOL1 genetic testing into living kidney donor clinical evaluation.

James L Merle, Marissa C Kuo, Jessica Gacki-Smith, Akansha Agrawal, John Friedewald, Elisa J Gordon, Justin D Smith

Abstract read
In one paragraph

Article in Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

James L MerleDepartment of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.
Marissa C KuoDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Jessica Gacki-SmithNorthwestern University Feinberg School of Medicine, Chicago, IL, USA.
Akansha AgrawalDepartments of Surgery and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
John FriedewaldDepartments of Surgery and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.ORCID http://orcid.org/0000-0002-9344-9928
Elisa J GordonDepartment of Surgery, and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 1161 21st Avenue South, CCC-4309 MCN, 37232-2730, Nashville, TN, USA. elisa.gordon@vumc.org.ORCID http://orcid.org/0000-0003-0969-1998
Justin D SmithDepartment of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.

Funding

Integrating a culturally competent APOL1 genetic testing program into living donor evaluationR01DK128207 · NIDDK · NORTHWESTERN UNIVERSITY AT CHICAGO · PI AGRAWAL, AKANSHA, FRIEDEWALD, JOHN J · 2021 to 2025
$3.3M
NIDDK NIH HHS R01 DK128207
6 · The paper itself

Abstract

backgroundLiving donor kidney transplantation (LDKT) is the preferred treatment for patients with end-stage kidney disease, offering longer graft survival and improved quality of life. However, LDKT poses risks to living donors. Black living donors face disproportionately higher risks of postdonation kidney disease than White counterparts, necessitating deeper understanding of the factors contributing to this disparity. This study evaluated the implementation of the APOL1 Genetic Testing and Counseling Program at two transplant centers to improve donors' informed decision-making, which entailed examining the contextual factors influencing its adoption and sustainment.

methodsWe conducted a mixed-methods evaluation involving semistructured interviews guided by the Consolidated Framework for Implementation Research and surveys with transplant nephrologists to identify facilitators and barriers of intervention implementation.

resultsEleven nephrologists participated. Key facilitators included alignment with clinical priorities, strong organizational support, and value attributed to the intended goal of enhancing donors' informed consent process and to the integration of culturally sensitive counseling practices. Key barriers included time constraints and the need for clear evidence-based guidelines. Participants reported high acceptability, appropriateness, feasibility, and sustainability of the APOL1 Program.

conclusionOur study identified facilitators and barriers that should be addressed to ensure the APOL1 program's sustainment and potential to improve donors' informed consent. Future research should leverage system-level implementation strategies to overcome identified barriers when taking the APOL1 Genetic Testing and Counseling Program to scale.

Indexed as

Apolipoprotein L1Genetic TestingKidney Failure, ChronicKidney TransplantationLiving DonorsAdultFemaleGenetic CounselingHumansInformed ConsentMaleMiddle AgedAPOL1 protein, humanApolipoprotein L1BlackCounselingCulturally targeted interventionImplementation scienceInformed consent

Identifiers

PMID40498120
PMCPMC12254160

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.