patient will think they’re an identical twin, but they’ve never been tested, so they don’t know for sure,” says Dr. Jorgensen. “Maybe doctors put these patients on immunosuppressants just in case.” Doctors also tend to use immunosuppressants for patients with glomerulonephritis — inflammation of the kidneys’ tiny filters — due to fears that the disease would recur in the transplanted kidney. Transplanted kidneys did tend to fare slightly worse in patients with glomerulonephritis, the study showed, but there were not enough cases to draw conclusions about the benefits of immunosuppression for these patients. “Long-term immunosuppressant use leaves patients vulnerable to infections, cancer, diabetes, and high blood pressure, so it’s best to avoid them for identical twin transplants if possible,” says Sundaram Hariharan, MD, professor of medicine in the Renal-Electrolyte Division and medical director of kidney and pancreas transplantation at UPMC, and senior author on the study. “If you ask me, I’m very comfortable withholding immunosuppressants from a patient who receives a kidney from their identical twin,” says Dr. Hariharan, who also is the Robert J. Corry Chair of Surgery at the University of Pittsburgh. “Every transplant patient will have surveillance to quickly detect potential organ rejection. They can be put on immunosuppressants later if the need arises.” Renal-Electrolyte Division faculty member Christine Wu, MD, also contributed to the study. Dr. Wu is an associate professor of medicine, and she currently serves as the Transplant Nephrology Fellowship program director. Her clinical and research interests lie in the selection of kidney transplant recipients and wait list management, kidney transplantation in the elderly, and the impact of co-morbidity on transplant outcomes. References 1 Jorgensen DR, Wu CM, Hariharan S. Epidemiology of End-Stage Renal Failure Among Twins and Diagnosis, Management, and Current Outcomes of Kidney Transplantation Between Identical Twins. Am J Transplant. 2019; doi: 10.1111/ajt.15638. Epub ahead of print. ABOUT THE UPMC RENAL-ELECTROLYTE DIVISION Thomas R. Kleyman, MD Professor of Medicine Chief, Renal-Electrolyte Division Address correspondence to: A915 Scaife Hall 3550 Terrace St. Pittsburgh, PA 15261 Phone: 412-647-3118 Fax: 412-647-6220 Email: kleyman@pitt.edu For consults and referrals, please call UPMC’s 24-hour physician OnDemand service at 1-866-884-8579. USNW513101 AS/MP 1/20 © 2020 UPMC A $20 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates 89,000 employees, 40 hospitals, 700 doctors’ offices and outpatient sites, and a nearly 3.6 million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, UPMC contributed $1.2 billion in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution, and paid $587 million in federal, state, and local taxes. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside on its annual Honor Roll of America’s Best Hospitals and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. For more information, go to UPMC.com. To learn more about the UPMC Renal-Electrolyte Division, please visit UPMCPhysicianResources.com/Kidney. 200 Lothrop St. Pittsburgh, PA 15213-2582 The Renal-Electrolyte Division is devoted to clinical care and academic excellence, and training the next generation of nephrologists. Our multidisciplinary approach provides the highest quality care for patients with complex kidney and electrolyte disorders. • Inpatient services at UPMC Presbyterian focus on patients with acute kidney injury, chronic kidney disease, end-stage kidney disease, and patients awaiting or who have received kidney transplants. Our on-site dialysis center performs nearly 10,000 dialysis treatments a year in various settings. • Outpatient services are provided at our specialized kidney and multidisciplinary clinics treating a variety of kidney and hypertensive disorders. • The Pittsburgh Center for Kidney Research, one of eight nationwide NIDDKsupported George M. O’Brien Kidney Research Core Centers, supports more than 110 investigators and provides funding for pilot projects. APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO): Design and Rationale Barry I. Freedman1 , Marva M. Moxey-Mims2 , Amir A. Alexander3 , Brad C. Astor4 , Kelly A. Birdwell5 , Donald W. Bowden6 , Gordon Bowen7 , Jonathan Bromberg8,9 , Timothy E. Craven3 , Darshana M. Dadhania10,11, Jasmin Divers3 , Mona D. Doshi12, Elling Eidbo13, Alessia Fornoni14, Michael D. Gautreaux15, Rasheed A. Gbadegesin16, Patrick O. Gee17, Giselle Guerra14,18, Chi-yuan Hsu19, Ana S. Iltis20, Nichole Jefferson21, Bruce A. Julian22, David K. Klassen23, Patrick P. Koty24, Carl D. Langefeld3 , Krista L.