The authors of the 2018 KDIGO hepatitis C guideline1 have provided a valuable service in clarifying their position on the allocation of HCV NAT-positive kidneys. Their original guideline statement read: “We recommend that transplantation of kidneys from HCV NAT-positive donors be directed to recipients with positive NAT.” As expressed in the KDOQI US commentary on this guideline,2 our plain-language interpretation of this recommendation was that HCV NAT-positive donor organs should be preferentially directed to recipients with HCV viremia versus transplant candidates without HCV viremia.