ORIGINAL RESEARCH
Transpl. Int.
The individual impact of machine perfusion on liver and kidney on donor expansion in simultaneous liver and kidney transplantation
- RO
Rikako Oki
- IR
Ingrid Rocha
- SA
Saleh Al-Juburi
- LR
Luckshi Rajendran
- EK
Emily Kerby
- AM
Adhnan Mohamed
- AA
Abbas Al-Kurd
- AN
Ahmed Nassar
- DY
Dean Yonghoon Kim
- AY
Atsushi Yoshida
- MA
Marwan Abouljoud
- SN
Shunji Nagai
Henry Ford Hospital, Detroit, United States, Michigan
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
Machine perfusion (MP) use for both organs can increase organ usage in simultaneous liver and kidney transplantation (SLKT). We analyzed 6,956 SLKT performed between 2015 and 2024 using the United Network for Organ Sharing database. The primary outcomes were the 1-year graft survival for kidney and liver. Donor types and MP use for liver and/or kidney were captured and associations with outcomes were evaluated. SLKT from Donation after circulatory death donors (DCD) increased from 4.5% in 2015 to 16% in 2023. The median Kidney Donor Profile Index (KDPI) has increased from 23% in 2015 to 28% in 2023. MP use for kidney and liver also increased from 21% to 51% and 0% to 17%, respectively. KDPI>85% was an independent risk factor of 1-year kidney graft failure in the no kidney MP group [HR 2.03, 95%CI1.20-3.44, p=0.009], but not in the kidney MP group. DCD was found to be an independent risk factor of 1-year liver graft failure in the no liver MP group [HR 1.56, 95%CI 1.19-2.03, p=0.001], but not in the liver MP group. MP for both organs may contribute to expanding the donor pool for SLKT without compromising post-transplant outcomes.
Summary
Keywords
Donation after Circulatory death, donor expansion, Kidney Donor Profile Index, machine perfusion, simultaneous liver and kidney transplantation
Received
22 April 2025
Accepted
27 August 2025
Copyright
© 2025 Oki, Rocha, Al-Juburi, Rajendran, Kerby, Mohamed, Al-Kurd, Nassar, Kim, Yoshida, Abouljoud and Nagai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Shunji Nagai, snagai1@hfhs.org
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.