Despite an increase in the number of kidney transplants performed annually, there remain more than 90,000 individuals awaiting transplantation in the United States. As kidney transplantation has evolved, so has kidney allocation policies. The Kidney Allocation System, which was introduced in 2014, made significant strides to improve utility and equity, but regional and geographic disparities remain. Further modifications eliminating donor service areas have been introduced. Moving forward, systems involving continuous distribution and artificial intelligence may provide further advancement toward an ideal allocation system.
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