A lot of the reason for the region by region waitlist is what you said, to make sure you are capable to get into the hospital within a certain amount of time to

A lot of the reason for the region by region waitlist is what you said, to make sure you are capable to get into the hospital within a certain amount of time to receive the organ. The other part is that it takes time to physically move an organ from the deceased to the transplanting hospital. Time is the key here, the more time the organ is not in a living body, the less likely it is to survive transplantation. So if we didn't have regions, and you were living in San Fransisco and a kidney came from a dead biker in Florida, the likelihood of the kidney surviving is less than if that kidney came from Sacramento.