Kidney transplantation saves lives, improves patients’ quality of life, and it is less costly in the long run compared with dialysis treatments.1,2 Despite this, kidney transplantation remains underused in the United States. Fewer than 20% of patients who initiate hemodialysis are placed on the deceased donor kidney transplantation waiting list or receive a kidney transplant within 1 year of dialysis initiation.3 A complex constellation of systemic factors contribute to low kidney transplantation rates, including low organ donation rates,4,5 organ allocation system rules,6,7 patient factors (eg, transplant knowledge and preferences),8,9 physician factors (eg, infrequent discussions about transplantation with patients),10 and health care organizational barriers (eg, suboptimal communication between dialysis facilities and transplant centers).11