OBJECTIVES: Marginal donor kidneys are increasingly used for transplantation to overcome organ shortage. This study aims to investigate the additional value of Power Doppler (PD) imaging in kidney quality assessment during normothermic machine perfusion (NMP). METHODS: Porcine kidneys (n = 22) retrieved from a local slaughterhouse underwent 2 h of NMP. Based on creatinine clearance (CrCl) and oxygen consumption (VO RESULTS: FI and VFI moderately correlated with CrCl (r = 0.537, p <
0.0001
r = 0.536, p <
0.0001, respectively), while VI strongly correlated with VO CONCLUSIONS: PD metrics strongly correlate with renal viability and effectively differentiate kidneys with higher and lower functionality during NMP. PD imaging can be a valuable alternative to RBF during NMP for kidney quality assessment.