The Health Resources and Services Administration (HRSA), an agency of the United States Department of Health and Human Services identified fair access and reduction of geographic disparities as the top priorities in the Organ Procurement and Transplantation Network (OPTN) “Final Rule,” a federal regulation passed in March 2000.1 The Final Rule was developed explicitly to minimize the disparities associated with a candidate’s place of residence or place of listing, which are based off arbitrary geographic boundaries.