*Purpose: The shortage of organs supplies and increased number of waiting patients for organs transplantation allowed to review historical contraindication for donation. Due to limited data and concerns for higher risk of infection in critically ill patients. No clear recommendations have been recognized for utilization of these organs. This study reviewed the safety and outcome of using organs from donors with open abdomen due to traumatic injuries and surgical intervention.

*Methods: A large organ procurement organization donor registry was retrospectively reviewed for last 5 years for donors with open abdomen after abdominal trauma.

*Results: Since 2014-2019, ten donors were identified with open abdomen due to surgical intervention after traumatic injuries. Twenty-eight organs (14 kidneys, 7 livers, 4 hearts, 2 lungs,1 pancreas) were procured from eight donors. Median age was 26 (16-40) years, 5 were males, mean follow up 3.6 years. Peritoneal swab and blood cultures performed at time of organs recovery. Blood culture was positive in only one donor. Appropriate antibiotics coverage was initiated in all recipients with regular postoperative immunosuppression regimen. From 28 recipients 2 patients (one liver and one heart) died (7%) after 13 months and 2.5 years respectively. Also, one recipient had kidney failure. All other recipients are alive with functioning organs.

*Conclusions: To best of our knowledge, this study reports the largest number of recipients received organs from donors with open abdomen. It is safe to use these organs for transplantation from selective donors and should not overlooked. However, aggressive surveillance for infections should be pursue and treated appropriately.

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