Aubert O, Reese PP, Audry B, et al. - Through a nationwide study using approved registries from the United States and France including comprehensive cohorts of deceased donors with organs offered to kidney transplant centers between January 1, 2004, and December 31, 2014, researchers evaluated the impacts of more aggressive allograft acceptance practices on the donor pool and allograft survival for the population of US wait-listed kidney transplant nominees. In the United States and France, 156,089 and 29,984 kidneys were recovered from deceased donors between 2004 and 2014, of which 128,102 and 27,252 were transplanted, and 27,987 and 2,732 were rejected, respectively. Kidney quality exhibited small variation in the United States over time, whereas a undeviatingly ascending kidney donor risk index in France highlighted a temporal trend of more dynamic organ use. It was discovered that 17,435 of kidneys that were rejected in the United States could have instead been transplanted under the French system. It was further ascertained that over the 10-year observation period, an extra 132,445 allograft life-years could be produced in the United States via a redesigned system with more aggressive organ acceptance practices. Hence, it was concluded that greater approval of kidneys from deceased donors who are elderly and have more comorbidities could give significant survival advantages to the population of US wait-listed individuals.