Objective: Intensive care unit (ICU) is a specialized area provides critical care and life support for acutely ill and injured patients. It also plays a crucial role in end-of-life care of patients with terminal illness or devastating injury where recovery seem to be impossible. The study took place at ICU Hospital Melaka with the main objective to compare between passive donor detection practiced in year 2019 and active donor detection in year 2022 after establishment of organ procurement unit (OPU). 
Materials and Methods: This is a 2-year retrospective study involving all deceased in ICU comparing January to December 2019 and January to December 2022. All eligible donors or deceased which were fulfilled the 3 medically suitable criteria i) Absent of high-risk behaviour and infective disease, ii) Absent of overwhelming sepsis, and iii) Absent of malignancy involving head and neck or haematological malignancy, were recorded. Data was further analysed into different types of death among the eligible donors, total number of family approach done for organ and tissue donation and how many had become actual donors.
Results: Percentage of eligible donor in year 2019 and 2022 were almost similar, which were 19.7% (57 deceased out of 298) and 16.4% (79 deceased out of 483) respectively. Causes of death of eligible donors in 2019 and 2022 were similar too, which consisted of trauma (47.4% and 40.5%), cerebrovascular accident (7% and 22.8%), and cardiovascular events (33.3% and 22.8%). Total of family approach done among eligible donors in 2022 for organ and tissue donation is higher, 51 out of 79 (64.6%); compared to 2019, 18 out of 57 (31.6%). 11 out of 79 (13.9%) of the eligible donors becoming actual donors in 2022 while only 1 out of 57 (1.8%) of the eligible donors becoming actual donors in 2019.
Conclusions: The active donor detection in ICU practiced in 2022 was more effective than passive donor detection in 2019. It facilitated more detection of eligible donors and promote more family approach. Thus, number of actual donors were increased.