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To address this knowledge gap, we developed a conceptual framework that takes into account all major domains of influence, including political and societal aspects as well as clinical implementation. The framework was initially constructed based on a targeted review of the relevant medical literature. Feedback provided by a panel of international experts was incorporated into the framework <jats:italic>via<\/jats:italic> an iterative process. The final framework features 16 essential domains that are critical for initiating and maintaining a successful program and improving the health of patients with organ failure. Of particular note, these domains are subject to three overarching health system principles: responsiveness, efficiency, and equity. This framework represents a first attempt to develop a whole-system view of the various factors that contribute to the success of a national program. These findings provide a useful tool that can be adapted to any jurisdiction and used to plan, evaluate, and improve organ donation and transplantation programs.<\/jats:p>","DOI":"10.3389\/ti.2023.11006","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T14:00:07Z","timestamp":1685023207000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["A Conceptual Framework for Evaluating National Organ Donation and Transplantation Programs"],"prefix":"10.3389","volume":"36","author":[{"given":"Charlotte","family":"Johnston-Webber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Mah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Streit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolos","family":"Prionas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Wharton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Mossialos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassilios","family":"Papalois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1093\/intqhc\/mzg049","article-title":"Conceptual Frameworks for Health Systems Performance: a Quest for Effectiveness, Quality, and Improvement","volume":"15","author":"Arah","year":"2003","journal-title":"Int J Qual Health Care"},{"key":"B2","volume-title":"Framework for Assessing, Improving and Enhancing Health Service Planning","author":"Fazekas","year":"2010"},{"key":"B3","volume-title":"Guide to the Quality and Safety of Organs for Transplantation","year":"2018"},{"key":"B4","volume-title":"Newsletter Transplant - European Directorate for the Quality of Medicines & HealthCare - EDQM","year":"2022"},{"key":"B5","volume-title":"ODEQUS - Organ Donation European Quality System","year":"2021"},{"key":"B6","volume-title":"Eurotransplant International Foundation 2018 Annual Report","year":"2018"},{"key":"B7","doi-asserted-by":"publisher","first-page":"S109","DOI":"10.1097\/TP.0000000000001769","article-title":"KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors","volume":"101","author":"Lentine","year":"2017","journal-title":"Transplantation"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/kisup.2012.73","article-title":"KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"3","year":"2013","journal-title":"Kidney Inter"},{"key":"B9","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1038\/ki.2009.377","article-title":"KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients: a Summary","volume":"77","author":"Kasiske","year":"2010","journal-title":"Kidney Int"},{"key":"B10","volume-title":"Guidelines for Living Donor Kidney Transplantation","year":"2020"},{"key":"B11","volume-title":"Intensive Care Society, Consensus Statement on Donation after Circulatory Death 2010","year":"2020"},{"key":"B12","volume-title":"Living Donor Liver Transplantation","year":"2020"},{"key":"B13","volume-title":"Transplantation from Deceased Donors after Circulatory Death","year":"2013"},{"key":"B14","first-page":"152","volume-title":"ERA-EDTA Registry Annual Report 2018","year":""},{"key":"B15","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1007\/s10561-010-9226-0","article-title":"WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation","volume":"11","year":"2010","journal-title":"Cell Tissue Bank"},{"key":"B16","doi-asserted-by":"publisher","first-page":"S29","DOI":"10.1097\/01.tp.0000399131.74618.a5","article-title":"The Madrid Resolution on Organ Donation and Transplantation. 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