A Look into a New Approach to Transplant Program Evaluation—the COIIN Project


Purpose of Review

Current kidney transplant program performance assessment metrics are reviewed, including their use by regulatory entities, and a new approach to program assessment, the Collaborative Innovation and Improvement Network (COIIN), is described.

Recent Findings

Current kidney transplant program performance assessment is based on 1-year patient and graft survival data. Program specific reports used by the OPTN, CMS, and third-party payers have resulted in risk-averse clinical decision making by transplant programs limiting the transplantation of less than ideal kidneys and access to transplantation for increased risk recipient candidates. In response, HRSA has funded the COIIN project as an alternative performance monitoring approach based on a data-rich, real-time, collaborative, monitoring framework. The goal is to reduce risk-avoidance decision making allowing the transplantation of a broader range of kidneys into appropriate recipients.


The COIIN project is a 3-year effort being piloted in a diverse group of transplant programs as an alternative to current performance metrics. If successful, this may replace the current performance monitoring system.

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Papers of particular interest, published recently, have been highlighted as: • of importance •• of major importance

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Corresponding author

Correspondence to David K. Klassen.

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Conflict of Interest

Henrisa Tosoc-Haskell reports that she is a director of Member Quality at United Network of Organ Sharing/Organ Procurement Transplant Network, a contractor under the direction of HRSA. David Klassen and Maureen McBride declare no conflict of interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on OPTN Policy

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Klassen, D.K., McBride, M.A. & Tosoc-Haskell, H. A Look into a New Approach to Transplant Program Evaluation—the COIIN Project. Curr Transpl Rep 4, 59–66 (2017). https://doi.org/10.1007/s40472-017-0140-2

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  • Risk aversion
  • Performance metrics
  • Program specific reports
  • Kidney transplantation
  • MPSC
  • CMS
  • Collaborative innovation and improvement network
  • HRSA
  • OPTN