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Background: Aquaporin-11 (AQP11) is a novel member of the aquaporin family. Disruption of the murine Aqp11 gene causes severe proximal tubular injury andrenal failure. The rs2276415 (G4A) single-nucleotide polymorphism in the humanAQP11 gene results in glycine to serine substitution in a functionally importantdomain. In this study, the role of the genetic predispositions of AQP11 rs2276415(G4A) on renal allograft outcomes was evaluated. Methods: A total of 198 pairs of donors and recipients were enrolled in this study. Long-term graft survival was traced and clinical parameters that could haveinfluenced graft outcome were collected through the electronic medical recordsystem. Results: The genotype distribution and allele frequency of rs2276415 polymorphismwere not different between donors and recipients. Despite similar allelefrequencies between donors and recipients, the minor allele rs2276415 (GAþAA)of AQP11 from the donors, but not from the recipients, had a harmful effect on thegraft survival compared with the wild-type donor (GG; P¼0.029). This associationwas significant after adjusting for several risk factors including age, sex, humanleukocyte antigen mismatch, donor type, hypertension, and diabetes mellitus(P¼0.032). Conclusion: A donor-derived, not recipient-derived, genetic AQP11 polymorphismhas different effects on graft outcome. Thus, the genetic influence from donorsshould be carefully considered for proper management of allografts after kidneytransplantation.

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