Sapiano MRP, et al. - Given that organ donors with risk factors for human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV) are categorized as increased risk donors (IRD) as per US Public Health Service guidelines, researchers investigated how IRD designation influences organ utilization using 2010-2017 data (21 626 heart, 101 160 kidney, 52 714 liver, and 16 219 lung recipients in the United States) from the Organ Procurement and Transplantation Network. Risk-adjusted utilization rates for IRD vs standard risk donors organs were not significantly different for adult hearts and livers and pediatric kidneys, livers, and lungs. Among IRD adult kidneys, lungs, and pediatric hearts, they noted significantly lower utilization. As per the analysis of the proportion of transplanted organs recovered from IRD by the facility, there appeared contribution of a subset of facilities to the underutilization of adult IRD kidneys. Beside considering revised criteria and nomenclature to identify donors with HIV, HBV, or HCV risk factors, they favor educational efforts to standardize informed consent discussions to improve organ utilization.