Ethiopia's Tigray War: the agony of survival in kidney transplant recipients.

A war between the Ethiopian federal government and Tigray regional government broke out on November 4, 2020 and is still ongoing. Regardless of the cause of the war, the civilian populations, who have no agency in the fighting, have often been at the receiving end of atrocities. Eight months into the war, a siege was imposed in Tigray, barring the entry of all forms of humanitarian aid, including food and medicines. As a result, civilians who survived hostilities are dying from hunger and diseases due to the blockade which has been put in place. One particular group of patients whose survival is at stake encompasses those with end-stage kidney disease, including kidney transplant recipients. The leading challenges of providing care to this group of patients amidst war and blockade include a barely functioning dialysis service, due to dwindling supplies, lack of access to the country's kidney transplant center in Addis Ababa, and severe shortages of immunosuppressive medications. To put this into perspective, we report on a 45-year-old female recipient of a kidney transplant at St. Paul's Hospital in Addis Ababa who succumbed in the besieged Tigray region as a result of lack of access to her transplant medicines. We urgently call upon the international nephrology societies and kidney transplant associations to advocate access to immunosuppressive medications for kidney transplant recipients in Tigray, Northern Ethiopia, to avert additional catastrophic events like the reported one.