Kidney Transplantation in Western Balkans: A Regional Blueprint for Access, Capacity, and Equity
There is no medical field where the impact of medical evolution is more palpable than in kidney transplantation. The pioneers of this procedure, 70 years ago, laid out the foundation for organ transplantation in general and kidney transplantation in particular. Despite the incredible advancements that have been made since, huge differences exist worldwide in terms of access, equity and quality of care. Nowhere are these disparities more prominent than in developing countries with limited resources, underfunded healthcare systems and transplantation infrastructures, particularly the Western Balkans. This position paper delineates the biggest barriers hindering the development of kidney transplantation in the Western Balkans, put forth and agreed upon by a group of regional experts on the field, based on the Modified Delphi Method. Limitations in training, infrastructure, restrictive and outdated legislative practices, lack of a centralized coordination network and fragmented regional collaboration, emerged as the principal challenges. Endorsed by European Society for Organ Transplantation (ESOT), this paper outlines a pragmatic and practical framework to overcome these obstacles, towards building robust and sustainable transplantation programs that ensure high-quality and equitable access to kidney transplantation, for all patients in this region.
Authors
- Efstratios Chatzixiros (ORCID: https://orcid.org/0000-0003-0675-6530)
- Damir Rebić (ORCID: https://orcid.org/0000-0003-4296-9453)
- Devi Mey
- Elvana Rista (ORCID: https://orcid.org/0000-0003-1490-8290)
- G. Spasovski
- Kristi Saliaj
- Jamil Azzi (ORCID: https://orcid.org/0000-0002-6909-4645)
- Danilo Radunović (ORCID: https://orcid.org/0000-0001-8417-9199)
- Jelena Stojanović (ORCID: https://orcid.org/0000-0001-9887-9081)
- Mirjana Laušević (ORCID: https://orcid.org/0000-0002-6029-9142)
- Fernanda Ortiz
- Alma Idrizi
- Ariana STRAKOSHA
- Carmen Lefaucheur
- Emin Baris Akin
- Luciano Potena
- Vjollca Godanci
Institutions
- European University of Tirana (AL)
- Brigham and Women's Hospital (US)
- University of Helsinki (FI)
- Harvard University (US)
- Istanbul Bilim University (TR)
- Université Paris Cité (FR)
- Great Ormond Street Hospital for Children NHS Foundation Trust (GB)
- Helsinki University Hospital (FI)
- Mother Teresa Hospital (AL)
- Saint Louis University Hospital (US)
- University of Belgrade (RS)
- University Clinical Center of Kosovo (XK)
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Assistance Publique – Hôpitaux de Paris (FR)
- World Health Organization (CH)
- Clinical Center University of Sarajevo (BA)
- Univerzitetski Klinički Centar Srbije (RS)
- Hygeia Hospital (GR)
- University Clinical Centre (PL)
- Nightingale Hospital (IN)
- European Society for Organ Transplantation (IT)
- University of Montenegro (ME)
- Ss. Cyril and Methodius University in Skopje (MK)
Publication Details
- Journal
- Transplant International
- Published
- 2026-03-13
- DOI
- https://doi.org/10.3389/ti.2026.15952
- Primary Topic
- Organ Donation and Transplantation
- Type
- article
- Field-Weighted Citation Impact
- 0.00