{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:22:25Z","timestamp":1782948145942,"version":"3.54.5"},"reference-count":76,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Health system performance assessment helps identify areas for improvement and guides policy initiatives. Although well-validated indicators exist for measuring organ donation and transplantation performance at the facility level, consensus on indicators for assessing national programmes is lacking. The aim of this study was to develop a comprehensive scorecard for evaluating national organ donation and transplantation programmes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A three-step approach was used. First, a targeted literature review identified potential indicators from regulatory documents, national transplant organization reports, and databases. Second, indicators were mapped to an established transplant system framework and refined through preliminary expert consultations. Third, a modified Delphi consensus process validated the indicators. The Delphi panel comprised international experts in health policy, organ donation, transplantation, and patient representation. Participants rated 168 indicators using a five-point Likert scale across two rounds (24 experts completed round 1 and 22 experts completed round 2). Consensus for inclusion required 80% agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 168 indicators evaluated, 103 achieved consensus for inclusion. After consolidation of organ-specific indicators, the final set contained 84 indicators across seven domains: monitoring and reporting (8 indicators), prevention and need (9 indicators), waiting lists (11 indicators), consent (4 indicators), donation (28 indicators), transplantation (14 indicators), and follow-up (10 indicators). The indicator set incorporates established metrics such as waiting list statistics, donation rates, and complication rates alongside novel system-level indicators addressing structural factors, patient-centredness, and equity in care delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This validated indicator set provides a standardized tool for assessing and comparing transplant system performance across European countries, supporting performance benchmarking and evidence-informed policy development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znaf293","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T12:22:41Z","timestamp":1767615761000},"source":"Crossref","is-referenced-by-count":1,"title":["Performance indicators for organ donation and transplantation programmes in Europe: modified Delphi consensus study"],"prefix":"10.1093","volume":"113","author":[{"given":"Simon","family":"Streit","sequence":"first","affiliation":[{"name":"Institut f\u00fcr Neuropathologie, Charit\u00e9 Universit\u00e4tsmedizin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6544-3636","authenticated-orcid":false,"given":"George","family":"Wharton","sequence":"additional","affiliation":[{"name":"Department of Health Policy, London School of Economics and Political Science , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4391-4286","authenticated-orcid":false,"given":"Jasmine","family":"Mah","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Dalhousie University , Halifax, Nova Scotia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"van Kessel","sequence":"additional","affiliation":[{"name":"Department of Health Policy, London School of Economics and Political Science , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolos","family":"Prionas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Imperial College , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Johnston-Webber","sequence":"additional","affiliation":[{"name":"Department of Health Policy, London School of Economics and Political Science , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Boletis","sequence":"additional","affiliation":[{"name":"Transplantation Unit, Laiko Hospital , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Dom\u00ednguez-Gil","sequence":"additional","affiliation":[{"name":"Organizaci\u00f3n Nacional de Trasplantes , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Forsberg","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Fran\u00e7a","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas do Sangue e da Transplanta\u00e7\u00e3o , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale","family":"Gardiner","sequence":"additional","affiliation":[{"name":"NHS Blood and Transplant , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Jeurissen","sequence":"additional","affiliation":[{"name":"Radboud Institute for Health Sciences, IQ Healthcare Scientific Institute for Quality of Healthcare , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8000-3185","authenticated-orcid":false,"given":"Irene","family":"Papanicolas","sequence":"additional","affiliation":[{"name":"Department of Health Policy, London School of Economics and Political Science , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Pearcey","sequence":"additional","affiliation":[{"name":"West London Kidney Patients\u2019 Association , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Romagnoli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. 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