DuBay DA, Morinelli TA, Su Z, et al. - Given the Organ Procurement and Transplantation Network (OPTN) approved alterations to the US kidney allocation system in 2019, researchers herein estimated the impact of the OPTN kidney allocation policy on regions of the US currently showing low rates of renal transplant, when accounting for the regional burden of end-stage kidney disease (ESKD). Access of ESKD patients to kidney transplant in the US was examined via this cross-sectional population-based economic evaluation. Patients with incident ESKD, those on the renal transplant wait list, as well as those who received a kidney transplant, all took part in this study. Across the US, a 3-fold variation was seen in the likelihood of a patient with ESKD receiving a deceased donor kidney transplant (from 6.36% in West Virginia to 18.68% in the District of Columbia). Findings indicate that geographic disparities in access to transplants may worsen following the implementation of the new OPTN-approved kidney allocation policy, when measured against the burden of ESKD within a particular region of the US.