Machine perfusion distribution across clinical phenotypes in kidney transplantation: A national cohort study using unsupervised clustering

Table 4 Resulting clusters phenotype summary

Cluster	Core phenotype	Immunologic profile	Outcomes	Allocation/time	MP type	Key modifiers	Transplant centre
1	Young, donor low cardiovascular comorbidity, donor behavioural risk	Low risk (fewer DR/B mismatches)	Intermediate graft survival. Patient survival↑	Low matchability score; recent years	NMP		No local
2	Older, comorbid males	Intermediate risk (DRMM = 1 enriched)	Graft and patient survival↓. Immediate graft function↓	Low matchability score	HMP/NMP	Donor quality↓, ↑(MP subgroup)	No local
3	Immunologically favourable; shorter waiting time, predominantly white recipients	Very low/near-perfect matching (DRMM = 0 dominant)	Graft and patient survival↑	Low matchability score; earlier years	HMP	Shorter CIT (MP subgroup); less dialysis at transplant	Local
4	Immunologically unfavourable, diverse recipient ethnicity, donor risk factors	High risk (DRMM = 2, BMM = 2 enriched)	Graft and patient survival↑ in full cohort	High matchability score; later years	NMP	Longer CIT (MP subgroup); hemodialysis at transplant (MP subgroup)
5	Young, females, donor low cardiovascular comorbidity	Intermediate risk	Graft and patient survival↑	High matchability score; earlier years	HMP	Less dialysis at transplant	Local
6	Older, donor hypertension with no behavioural risk	Intermediate risk	Intermediate graft and patient survival	High matchability score	HMP		Local

B: B locus; BMM: Number of mismatches at B locus; DR: DR locus; DRMM: Number of mismatches at DR locus; HMP: Hypothermic machine perfusion; NMP: Normothermic machine perfusion; CIT: Cold ischemia time.