This article was adapted from “Every Living Creature" by Joshua D. Mezrich. My phone rang at 2 a.m. I was mostly awake; I never really sleep on call. As I rubbed my eyes, I tried to focus on the voice coming through the phone. One of our coordinators was telling me about a kidney offer, and she launched right into it: “68-year-old donor, diabetes and high blood pressure, died of a stroke, kidney function normal, biopsy with some scarring and inflammation. Do you want to hear more?” We evaluate offers like this all the time. The transplant waiting list is so long, with so many patients who will never receive an offer for a healthier organ. Do we take a risk and transplant a kidney like this? How long could it possibly last? It seems likely my patient might get a few years, but then return to dialysis for what might be the rest of their life.…