Background: According to national as well as the European regulations the basic guiding principle in organ donation and transplantation is “first, do not harm” Considering that almost all of those patients at the ICU are infected or colonised we need to find acceptable risk and balance ratio.
Methods: We evaluated 16 organ DBD donors, which met the criteria for severe sepsis at the admission time. 10 out of them suffered from severe bacterial CNS infection, 3 of them were admitted due to COVID19 pneumonia and 3 with active RSV related pneumonia. Risk/benefit ratio was evaluated according to the type of organ which planned to be recovered, taking into account  available literature data.  
Results: We accepted all the donors for multi organ procurement with bacterial meningitis or encephalitis, where the etiological agents was known in the time of organ procurement – we excluded microorganisms capable to create septic metastases such as Listeria spp. In the group of patients with an active RSV infection (by PCR from BAL), as well as COVID19 pneumonia, we accepted all the donors for multi organ procurement except the lungs. Together 56 organs were accepted for the transplantation. Recipient hospital was provided by the information related to the susceptibility of bacteria. The average antibiotic treatment time in recipients was 2.5 days. There was no known donor derived infection transmission into recipient.
Conclusions: As there is worldwide huge lack of the organs suitable for transplantation, we suggest to take into account only clinical relevant information and stay aware of “routine” praxis not to accept donor with even severe septic infection. Of course, risk and benefit validation has to be done.