Introduction: Severe burn injuries have historically been a contraindication to organ donation, particularly in patients with hemodynamic instability or suspected infection.  While donation from this population has been previously described, most publications focus on pediatric donors or those with smoke inhalation injuries.  We present procurement and transplant outcomes from a series of adult donors with burns as the primary contributing mechanism of death.
Method: Over the past decade, our OPO received 171 referrals of ventilated patients with reported burn injuries. Prior to 2022, potential donors with torso burn injuries were excluded due to infection risk during organ recovery.  Beginning in 2022, with the addition of a transplant infectious disease specialist to the OPO team, all referred burn patients were evaluated for potential donation regardless of burn severity or location.  Organ suitability was determined through comprehensive assessment of clinical history, organ function, and infection risk.
Results:  Between 1/1/2022 – 5/31/2025, NEDS received 61 referrals of ventilated patients with burn injuries as the primary admitting diagnosis.  Of these, 26% (n= 16) were deemed medically suitable for organ donation following multidisciplinary evaluation.  Authorization and successful organ recovery were achieved in 11 cases (69% of suitable referrals).  These 11 donors resulted in 27 transplanted organs, including 3 hearts and 7 livers.  Notably, 72% (n=8) of the donors had ≥ 50% TBSA burns. No donor-related infectious complications were reported among the recipients. 
Conclusion: Organ recovery from donors with extensive burn injuries is feasible and safe when guided by careful clinical and infectious risk assessments. Extrapolating from our recent data, earlier adoption of this model could have resulted in an estimated 28 additional donors and 68 more transplants over the preceding eight years.  Incorporating an infectious disease specialist into donor evaluation enables informed decisions on donor suitability and antimicrobial treatment, expanding access to transplantable organs.