Global Perspective on Kidney Transplantation: Bosnia and Herzegovina

What is it about?

Bosnia and Herzegovina (BiH) is a country in the Western Balkan which emerged after the collapse of the Second Yugoslavia and a 4-year war. The Law on Transplantation was considered progressive, but it was not well followed. The 1995 Dayton accord resulted in a complicated and unusual state structure. This has had a profound impact on all aspects of healthcare including transplantation._x000D_ We summarise the current situation with an emphasis on its unusual political situation and impact of ethnic and religious diversity. We will briefly touch upon the incidence and prevalence of kidney failure and dialysis provision. We will then discuss living transplantation. A significant number of transplants occur abroad, sometimes raising questions in relation to the Istanbul Declaration. In comparison, transplantation from deceased donors has been fraught with difficulty. We describe how nephrologists in BiH and their international supporters have sought to overcome the complex challenges. Transplantation in BiH continues to be hampered by financial constraints and ongoing political situation. These challenges have been compounded further by the COVID-19 pandemic. Nephrologists in BiH and their teams have sought to overcome these challenges and come up with creative solutions, supported by regional cooperation and a longstanding mentorship scheme through the International Society of Nephrology.

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