We interviewed Dr. Posner, Professor Emeritus of Vascular and Transplant Surgery and former Director of the Hume-Lee Transplant Center at VCU Health, to discuss the ethics surrounding the distribution of human organs and the patient factors that influence organ allocation. What variables should be considered when trying to maximize a patient’s benefit from an organ transplant? What improvements can be made to the current system of allocation to pursue a more equitable system? The origins of transplantation have a rich history, from its inception in the “God Committee” to current allocation systems and this episode endeavors to discuss the historical perspective of transplantation and how changes in this system have benefited and/or hindered patients seeking transplant.