{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:07:16Z","timestamp":1791209236370,"version":"4.1.0"},"reference-count":59,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"unspecified","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation","award":["NIHR203332"],"award-info":[{"award-number":["NIHR203332"]}]},{"DOI":"10.13039\/100009033","name":"NHS Blood and Transplant","doi-asserted-by":"publisher","award":["Clinical Research Fellowship"],"award-info":[{"award-number":["Clinical Research Fellowship"]}],"id":[{"id":"10.13039\/100009033","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,9,17]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study explores decision-making in organ transplantation. The number of patients waiting for a solid organ transplant continues to rise despite efforts to increase the available pool of donor organs. This has focused attention on maximising the number of organs offered that are subsequently transplanted, a process termed organ utilisation. There is a paucity of work exploring how clinicians decide to decline or accept offers of donor organs. This study aims to better understand the factors that influence organ utilisation decision-making in cardiac and thoracic transplantation through qualitative methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Semi-structured qualitative interviews undertaken online over a 5-month period. Data collection and analysis occurred simultaneously. Transcripts were inductively analysed to generate themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Clinicians representing all six adult UK cardiothoracic transplant centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Consultant cardiothoracic transplantation surgeons (n=9) and cardiothoracic transplant coordinators (n=10).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      19 interviews were undertaken. The following themes pertinent to utilisation decision-making were identified:\n                      <jats:italic>anticipation of outcomes; data; motivation; out-of-hours; micro-culture<\/jats:italic>\n                      and\n                      <jats:italic>experiential learning<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study is the first to explore the process of organ utilisation decision-making from a clinician\u2019s perspective through interviews. This documents an important and nuanced understanding of the interrelated factors involved in utilisation decision-making in practice. By providing evidence for the human inconsistencies in utilisation decision-making, this work may inform a more considered approach to strategies to improve utilisation rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121139","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:35:30Z","timestamp":1791207330000},"page":"e121139","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cIt\u2019s not necessarily science based\u201d: understanding organ utilisation decision-making in cardiothoracic transplantation in the UK through qualitative interviews"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3669-8629","authenticated-orcid":false,"given":"Rebeka","family":"Jenkins","sequence":"first","affiliation":[{"name":"Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Statistics and Clinical Studies, NHS Blood and Transplant, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Hardman","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Statistics and Clinical Studies, NHS Blood and Transplant, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Booth","sequence":"additional","affiliation":[{"name":"Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Dark","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Fisher","sequence":"additional","affiliation":[{"name":"Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK"},{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Exley","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2026100506352071000_16.10.e121139.1","doi-asserted-by":"crossref","first-page":"i29","DOI":"10.1093\/bja\/aer384","article-title":"Organ transplantation: historical perspective and current practice","volume":"108 Suppl 1","author":"Watson","year":"2012","journal-title":"Br J Anaesth"},{"key":"2026100506352071000_16.10.e121139.2","doi-asserted-by":"crossref","DOI":"10.21037\/atm.2018.09.68","article-title":"Solid organ transplantation in the 21st century","volume":"6","author":"Black","year":"2018","journal-title":"Ann Transl Med"},{"key":"2026100506352071000_16.10.e121139.3","unstructured":"NHS Blood and Transplant . 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