# Kidney Transplantation in Western Balkans: A Regional Blueprint for Access, Capacity, and Equity

## TL;DR

This paper outlines challenges and solutions for improving kidney transplantation access and quality in the Western Balkans.

## Contribution

A collaborative framework using the Modified Delphi Method to address regional barriers in kidney transplantation.

## Key findings

- Training, infrastructure, and outdated legislation are major barriers in the Western Balkans.
- A centralized coordination network is needed to improve regional collaboration.
- ESOT-endorsed solutions aim to ensure equitable and high-quality kidney transplantation.

## Abstract

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 Limitations in training, infrastructure, restrictive and outdated legislative practices, lack of a centralized coordination network and fragmented regional collaboration, emerged as the principal challenges.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.