Two renal-risk variants in the apolipoprotein L1 gene (APOL1), termed G1 and G2, are present in a large percentage of African American organ donors and kidney transplant recipients. Upon receiving deceased donor kidneys from African Americans with two APOL1 renal-risk variants, transplant recipients experience earlier allograft failure. Moreover, individuals who possess two APOL1 renal-risk variants are themselves more susceptible to developing nephropathy. These observations support testing for APOL1 renal-risk variants in deceased African American kidney donors to improve the organ allocation process. Determining APOL1 renal-risk variant status could better inform physicians and kidney transplant recipients about the projected outcomes of transplanted kidneys.

Atrium Health Wake Forest Baptist, under the scientific leadership of Barry I. Freedman, MD, section chief of nephrology, has developed and now offers APOL1 genetic testing with results within 7 days of receipt for potential live donors and patients at risk. 

Contact our Immunodiagnostics Laboratory to discuss same-day results for deceased donors. Speedy results enable physicians to make timely decisions based on the findings of the test.

Testing Availability

This test is currently available to order for physicians in the following states:

Washington DC
New Hampshire
New Mexico
North Carolina
North Dakota
South Carolina
South Dakota
West Virginia

Are you not in a state listed above? Contact us and share your email and we will let you know when we offer the APOL1 genetic test in your state.

How the APOL1 Genetic Test Works

The APOL1 test is an inexpensive and convenient personalized genetic test that reports on risk for non-diabetic nephropathy and more rapid failure of transplanted kidneys. The test may inform physicians about optimal allocation of donor kidneys and lead to improved patient care and outcomes. Genetic testing for potential live donors and patients at risk consists of a blood test. DNA is extracted from the sample, then amplified, sequenced, and assembled into a readable format for the physician.

Analysis of the sample can determine if a kidney donor (potential live kidney donor or deceased kidney donor) or a patient inherited two APOL1 gene renal-risk variants that contribute to poorer renal allograft survival after transplantation. Genetic testing might help determine if a donor kidney carries greater risk for renal complications after transplantation, such as a higher serum creatinine concentration or earlier allograft failure.

Testing Results and Benefits

APOL1 genetic testing can help you make informed decisions about how to manage future risks of allograft failure in your renal transplant patients. For example, if it is determined that a donor kidney is at greater risk for shortened allograft survival based on presence of two APOL1 renal-risk variants, rapid re-assessment of allocation of the kidney may be advisable.

Also, if you have patients with kidney disease and you determine that they possess two APOL1 renal-risk variants, they may be at increased risk for developing progressive renal failure.

Test results can help you develop an individualized plan of care for your patients. Results can be of great value to family members, including those considering donating a kidney. Counseling sessions are recommended to fully inform patients – before and after genetic testing – and may contribute to improved outcomes.

Frequently Asked Questions


Freedman, Barry I., et al. “APOL1 Genotype and Kidney Transplantation Outcomes From Deceased African American Donors.” Transplantation (2015).

U.S. Renal Data System, USRDS 2012 Annual Data Report, Vol 1: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. 2012

Reeves‐Daniel, Amber M., et al. “The APOL1 gene and allograft survival after kidney transplantation.” American Journal of Transplantation 11.5 (2011): 1025-1030.

Freedman, B. I., et al. “Apolipoprotein L1 gene variants in deceased organ donors are associated with renal allograft failure.” American Journal of Transplantation 15.6 (2015): 1615-1622.

Rapid APOL1 genetic testing services are protected by US 20130079244, Methods of predicting predisposition to or risk of kidney disease. Contact Wake Forest Innovations for licensing opportunities. © 2023 Wake Forest Baptist Medical Center. All Rights Reserved.

Barry Freedman, MD, Professor of Internal Medicine (Nephrology), Wake Forest University School of Medicine, is entitled to royalties from the APOL1 assays processed at Atrium Health Wake Forest Baptist Medical Center’s laboratory.