Higher levels of ALP have been shown to correlate with C-reactive protein values, with a hypothesis that higher ALP is associated with a chronic inflammatory milieu.21 Additional studies point to an association with osteoporosis and evidence that ALP promotes vascular calcification.20,22-24 The clinical significance of the difference noted in the present study is unclear and further studies may elucidate the causal pathways involved in the association of ALP and donor morbidity, as well as implications for clinical surveillance of donors with elevated ALP. The gene discussed is CRP; the disease is osteoporosis.