There is a profound shortage of organs in the United States, which has limited the number of patients who can benefit from the improvements in quality of life and survival that transplantation offers.1,2 Improving organ access equitably remains a public health priority.3,4 In this issue of AJKD, Kadatz et al5 examined whether changes in the kidney allocation system (KAS) introduced in 2014 were associated with differences in the likelihood of receiving kidney transplantation and outcomes after transplantation in patients with prolonged dialysis vintage (≥6.5 years).