Dialysis regulation: Transplant referral mandatory, capacity capped at 80 machines

The Ministry of Health published in the Official Gazette dated 13 November 2026 the new regulation on the opening, licensing and inspection of dialysis centres and on the treatment services offered to patients; the Regulation on Dialysis Centres dated 1 March 2019 was repealed.

The regulation requires that patients taken into scheduled dialysis for the first time be referred, within at most three months following the start of their treatment, to the nearest public organ transplant centre to be evaluated for kidney transplant. At organ transplant centres, patients will be given oral and written information about the transplant process, eligibility conditions, living and cadaver donor transplant options, and the benefits and risks of transplantation; those found suitable for transplant will be registered on the national waiting list. The information provided will be kept in the patient file and in the Ministry's digital record system. For patients who began dialysis treatment before the date the regulation was published, these procedures must be completed within one year.

Centres that obtain the necessary permit from the provincial health directorate for home haemodialysis may provide the service at the patient's request and with the patient's written consent; a separate machine will be allocated to each patient and medical checks will be carried out by the centre. Long-term haemodialysis may also be applied with the patient's consent and its duration may not be less than seven hours. Each patient will be evaluated by the relevant specialist physician at least once a month; treatment information and medical records will be entered into the Ministry's digital system.

Newly opening dialysis centres may initially have at least 15 and at most 25 machines. Whether existing centres increase their machine numbers will depend on the Ministry's planning; an increase of at most five machines at a time may be made, and existing capacity will not be allowed to exceed 80 machines. Second-hand dialysis machines will have to be no older than 10 years.

Centres will be obliged to ensure that patients treated at their facility reach the centre before dialysis and return to their homes after treatment; the service may be provided directly or purchased from transport companies. The regulation also sets out rules on the qualifications of health personnel, minimum personnel numbers during treatment sessions, infection control and inspection processes. Centres that were previously licensed may continue their activities in their current state.