Kakuzu and Tsunade should win mid-high difficulty. For this battle, Kakuzu's best option is to use his
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, which allows him to use threads defensively while his hearts cover his back. If Sasuke tries to blitz, he would get overwhelmed by threads coiling around all parts of his body while being at point blank range of Kakuzu's strongest attack. If Sasuke attempts genjutsu on Kakuzu, his hearts break him out while a Katsuyu clone on Tsunade's shoulder would break her out should she get caught in genjutsu.
Sooner or later, Kakuzu will use his
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which is immensely hot and powerful, with Tsunade
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it with her chakra to make it much stronger. Sasuke will have no choice but to summon Manda as a shield, which will proceed to
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. If Manda sneak attacks Kakuzu and swallows him, it will be useless since Domu would tank his bite and then Kakuzu would kill Manda from the inside out by burning away his organs. If Manda tries to sneak attack Tsunade, she
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its attack and then takes it down with a series of punches and kicks. While Manda attacks one, Sasuke will attack the other- but that's ok, because if he tries to close distance with Kakuzu and enter CQC, Kakuzu will catch him with threads and blow him away, and if he tries to enter CQC with Tsunade she will summon Katsuyu which pushes her up and far away from Sasuke.
Once Manda is out of the picture, Kakuzu just needs to use his fire and wind combo again with Tsunade enhancing it, and it's GG for Sasuke. The only threat is Kirin, but it took a forest burning on fire with black flames for a long duration to create the conditions for Kirin, and unlike Amaterasu Kakuzu's fire and wind attack will burn itself out and therefore not heat up the atmosphere as much. If you want an example, consider how Jiraiya used a
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and it did create storm clouds, same case with Obito and Madara when they used their massive katons.
in all seriousness, chidori stream or karin end Kakuzu's life. But Kakuzu doesn't die first, as Sasuke would be smart enough to know he should take out the medic first. Tsunade gets fried with Amaterasu, which she has no feats to dodge.
