Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;20(4):1076-1086.
doi: 10.1111/ajt.15657. Epub 2019 Nov 14.

The Collaborative Innovation and Improvement Network (COIIN): Effect on donor yield, waitlist mortality, transplant rates, and offer acceptance

Affiliations
Free article

The Collaborative Innovation and Improvement Network (COIIN): Effect on donor yield, waitlist mortality, transplant rates, and offer acceptance

Andrew Wey et al. Am J Transplant. 2020 Apr.
Free article

Abstract

The Organ Procurement and Transplantation Network implemented the Collaborative Improvement and Innovation Network (COIIN) to improve the use of donors with kidney donor profile index >50%. COIIN recruited 2 separate cohorts of kidney transplant programs. Cohort A included 19 programs of 44 applicants (January 1, 2017, to September 30, 2017), and cohort B included 39 programs of 47 applicants (October 1, 2017, to June 30, 2018). We investigated the effect of COIIN on kidney yield (number of kidneys transplanted from donors from whom any organ was recovered), offer acceptance, deceased donor transplant rates, and waitlist mortality rates for January 1, 2016, to March 31, 2019. COIIN did not notably affect kidney yield or waitlist mortality rates. Cohort A, but not cohort B, had significantly higher deceased donor transplant and offer acceptance rates during its intervention period than programs not in COIIN (adjusted transplant rate ratio: cohort A, 1.08 1.171.27 , cohort B, 0.94 1.011.08 ; adjusted offer acceptance ratio: cohort A, 1.08 1.181.29 , cohort B, 0.93 1.001.08 ). Thus, COIIN improved the use of kidneys at programs in cohort A but not at those in cohort B. Further research is necessary to understand the different effects for cohorts A and B, and further monitoring of posttransplant outcomes is required.

Keywords: Organ Procurement and Transplantation Network (OPTN); Scientific Registry for Transplant Recipients (SRTR); clinical research/practice; kidney transplantation/nephrology; organ procurement and allocation.

PubMed Disclaimer

References

REFERENCES

    1. Kasiske BL, Salkowski N, Wey A, Israni AK, Snyder JJ. Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States. Am J Transplant. 2016;16(12):3371-3377.
    1. Hamilton TE. Regulatory oversight in transplantation: are the patients really better off? Curr Opin Organ Transplant. 2013;18(2):203-209.
    1. Snyder JJ, Salkowski N, Wey A, et al. Effects of high-risk kidneys on Scientific Registry of Transplant Recipients program quality reports. Am J Transplant. 2016;16(9):2646-2653.
    1. Massie AB, Luo X, Chow EKH, Alejo JL, Desai NM, Segev DL. Survival benefit of primary deceased donor transplantation with high-KDPI kidneys. Am J Transplant. 2014;14(10):2310-2316.
    1. Wey A, Salkowski N, Kremers WK, et al. A kidney offer acceptance decision tool to inform the decision to accept an offer or wait for a better kidney. Am J Transplant. 2018;18(4):897-906.

Publication types