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The costs of potential donors are not fully known in Brazil, as in other countries, bespecially during the period that patients remain in intensive care units. This study aims to evaluate the cost of maintaining effective donors and nondonors of organs and tissues for transplants in intensive care units using the microcosting technique. An economic cost analysis using 3 retrospective cohorts constructed from secondary data collected over a 1-year period from medical records of deceased patients who had a protocol opened for brain death investigation. Cost measurement followed the 8 steps of the Time-Driven Activity-Based Costing method. The average cost of the effective donor was US$3220.04. The cost of the nondonor due to family refusal was US$1346.48. The cost of the nondonor due to medical refusal was US $1144.90. Organs and tissues donated but not collected totaled US$16,656.92. A review of work processes and adopting strategies to mitigate the failure to complete donations in all outcomes are necessary, since the sum of the amounts spent on medical refusal, family refusal, and problems preventing collection amounted to a total of US$104,121.66 in 1 year.