Implementation of the Kidney Allocation System (KAS) for deceased donor kidneys (DDKs) in the United States was intended to optimize kidney allocation, reduce disparities, and increase organ utilization.1 KAS incorporates the Kidney Donor Risk Index (KDRI), an estimate of the relative risk for transplant failure of a donor’s kidney versus the median donor. The KDRI (also expressible as a percentile score, the Kidney Donor Profile Index [KDPI]), is calculated using 10 donor-specific characteristics, thus de-emphasizing any single characteristic during the organ acceptance process.