Human decision-making is often guided by heuristics—cognitive shortcuts that can produce systematic biases. Whether such heuristics shape the judgments of highly trained experts remains a central question for organizational performance. We study the availability heuristic, whereby recent and salient adverse outcomes disproportionately influence subsequent decisions, in the context of U.S. kidney transplantation. We exploit the asynchronous arrival of information about early graft failure as a quasi-experimental “news shock” and examine whether this salient negative event affects subsequent kidney offer acceptance decisions. Using national data on nearly four million kidney offers and a difference-in-differences design, we find that a recent graft failure significantly reduces a transplant center’s willingness to accept subsequent organs. The effect is short-lived, concentrated in clinically ambiguous cases, and amplified when decision-makers face greater cognitive load. Additional analyses support a behavioral interpretation and help rule out organizational learning as an alternative explanation. These findings provide large-scale causal evidence of availability bias in a high-stakes organizational setting and suggest that operational interventions designed to buffer decision-makers from salient negative events may improve the efficiency of organ allocation.