Introduction: The processing fee from the Thai Red Cross for organ donation and transplantation management has been stabilized for years. This study aimed to identify the total processing cost to provide strategic feedback to the stakeholders.
Methods: A retrospective, descriptive, activity-based cost analysis. Data were collected between 2019 and 2022 from the organ donation and transplantation center database,  Khon Kaen Hospital, Khon Kaen, Thailand. This tertiary care referral hospital is a training center for organ donation, transplantation nurse coordinators, and a level-2 trauma center where major trauma patients, including severe traumatic brain injury, are referred. The data were collected since brain-dead, potential donors were notified by ward staff until the funeral ceremony was held. The harvested organs, the funeral ceremony, the laboratory, and the instrumental expenses were collected. The data was analysed descriptively by Microsoft Excel. 
Results: A total of 66 brain-dead donors at Khon Kaen Hospital were identified. 92.4% were male. The mean age was 38 years. The nurse coordinators were notified of the potential donors in the ICU for 72.7%. The most harvested organ was the kidney. The mean cost was 41,802 Thai Baht (184,830 Yen) per body. 
Conclusion: The collected costs were higher than the processing fee received from the Thai Red Cross. The results of the study are relevant for the stakeholders to make an up-to-date policy.