Three of the most robust findings in outcomes research in the field of kidney transplantation are that on average, kidney transplantation is associated with a significant survival benefit relative to dialysis, living donor transplantation is associated with superior outcomes compared to deceased donor transplantation, and the duration of pretransplantation dialysis therapy is associated with diminished outcomes following transplantation.1-3 Explanations for these findings are complex and multifaceted, but are pivotal considerations for informing decision making and policy development and guiding potential transplantation candidates and organ allocation policies.