{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:40:23Z","timestamp":1782301223602,"version":"3.54.5"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T00:00:00Z","timestamp":1647216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl Int"],"abstract":"<jats:p>Optimal kidney graft outcomes after simultaneous liver-kidney (SLK) transplant may be threatened by the increased cold ischemia time and hemodynamic perturbations of dual organ transplantation. Hypothermic machine perfusion (MP) of kidney allografts may mitigate these effects. We analyzed U.S. trends and renal outcomes of hypothermic non-oxygenated MP vs. static cold storage (CS) of kidney grafts from 6,689 SLK transplants performed between 2005 and 2020 using the United Network for Organ Sharing database. Outcomes included delayed graft function (DGF), primary non-function (PNF), and kidney graft survival (GS). Overall, 17.2% of kidney allografts were placed on MP. Kidney cold ischemia time was longer in the MP group (median 12.8 vs. 10.0\u00a0h; <jats:italic>p<\/jats:italic> &amp;lt; 0.001). Nationally, MP utilization in SLK increased from &amp;lt;3% in 2005 to &amp;gt;25% by 2019. Center preference was the primary determinant of whether a graft underwent MP vs. CS (intraclass correlation coefficient 65.0%). MP reduced DGF (adjusted OR 0.74; <jats:italic>p<\/jats:italic> = 0.008), but not PNF (<jats:italic>p<\/jats:italic> = 0.637). Improved GS with MP was only observed with Kidney Donor Profile Index &amp;lt;20% (HR 0.71; <jats:italic>p<\/jats:italic> = 0.030). Kidney MP has increased significantly in SLK in the U.S. in a heterogeneous manner and with variable short-term benefits. Additional studies are needed to determine the ideal utilization for MP in SLK.<\/jats:p>","DOI":"10.3389\/ti.2022.10345","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T09:44:17Z","timestamp":1652175857000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Trends and Outcomes of Hypothermic Machine Perfusion Preservation of Kidney Allografts in Simultaneous Liver and Kidney Transplantation in the United States"],"prefix":"10.3389","volume":"35","author":[{"given":"Alex","family":"Chang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas E.","family":"Schaubel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter L.","family":"Abt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Therese","family":"Bittermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1053\/jhep.2002.33160","article-title":"Pretransplant Renal Function Predicts Survival in Patients Undergoing Orthotopic Liver Transplantation","volume":"35","author":"Nair","year":"2002","journal-title":"Hepatology"},{"key":"B2","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1097\/tp.0b013e3182590d6b","article-title":"Combined Liver-Kidney Transplantation Is Preferable to Liver Transplant Alone for Cirrhotic Patients with Renal Failure","volume":"94","author":"Fong","year":"2012","journal-title":"Transplantation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2243","DOI":"10.1111\/j.1600-6143.2008.02416.x","article-title":"Proceedings of Consensus Conference on Simultaneous Liver Kidney Transplantation (SLK)","volume":"8","author":"Eason","year":"2008","journal-title":"Am J Transplant : official J Am Soc Transplant Am Soc Transpl Surgeons."},{"key":"B4","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1111\/ajt.15674","article-title":"OPTN\/SRTR 2018 Annual Data Report: Liver","volume":"20","author":"Kwong","year":"2020","journal-title":"Am J Transpl"},{"key":"B5","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1097\/tp.0b013e318168476d","article-title":"Declining Outcomes in Simultaneous Liver-Kidney Transplantation in the MELD Era: Ineffective Usage of Renal Allografts","volume":"85","author":"Locke","year":"2008","journal-title":"Transplantation"},{"key":"B6","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.jamcollsurg.2019.04.019","article-title":"A Tale of Two Kidneys: Differences in Graft Survival for Kidneys Allocated to Simultaneous Liver Kidney Transplant Compared with Contralateral Kidney from the Same Donor","volume":"229","author":"Cannon","year":"2019","journal-title":"J Am Coll Surgeons"},{"key":"B7","doi-asserted-by":"publisher","first-page":"Cd011671","DOI":"10.1002\/14651858.CD011671.pub2","article-title":"Machine Perfusion Preservation versus Static Cold Storage for Deceased Donor Kidney Transplantation","volume":"3","author":"Tingle","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"B8","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1038\/nrneph.2012.83","article-title":"New Strategies to Optimize Kidney Recovery and Preservation in Transplantation","volume":"8","author":"Bon","year":"2012","journal-title":"Nat Rev Nephrol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1097\/tp.0000000000003040","article-title":"Delayed Implantation of Pumped Kidneys Decreases Renal Allograft Futility in Combined Liver-Kidney Transplantation","volume":"104","author":"Lunsford","year":"2020","journal-title":"Transplantation"},{"key":"B10","unstructured":"A Guide to Calculating and Interpreting the Kidney Donor Profile Index (KDPI)2020"},{"key":"B11","unstructured":"Policy 8: Allocation of Kidneys2020"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2995","DOI":"10.1093\/ndt\/gfn158","article-title":"Marked Variation in the Definition and Diagnosis of Delayed Graft Function: a Systematic Review","volume":"23","author":"Yarlagadda","year":"2008","journal-title":"Nephrol Dial Transplantationofficial Publ Eur Dial Transpl Assoc - 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