Seven questions worth asking before you accept a transplant quotation

The single most useful question, and the one most often answered vaguely. A file reviewed by a transplant surgeon or a nephrologist produces a different conversation from a file processed by a coordinator working through a checklist.

The answer to listen for is a role and a specialty. "Our medical team" is not an answer. Neither is a photograph of a hospital.

A package price is genuinely useful — it makes the largest cost predictable. What makes it misleading is when the boundary is left vague, because the parts that fall outside are exactly the parts that vary.

Ask for the list, in writing. Then ask the two questions that follow from it: what happens to the price if the stay runs longer than planned, and whether the donor’s evaluation and surgery are inside the figure or outside it.

In most countries that permit living donation, medical clearance and regulatory approval are two separate decisions made by two different bodies. A programme that treats them as one thing — or that cannot name the authority — is describing a process it does not control.

The useful follow-up is how long approval usually takes, because that number, more than the surgical schedule, determines how long a family is abroad.

A living donor should be assessed by clinicians whose responsibility is the donor, separately from the team treating the patient, and should be able to ask questions without the patient in the room. This is not a courtesy. It is how a programme establishes that consent is real, and it is the safeguard that distinguishes legitimate living donation from the thing that imitates it.

If the same doctor is presented as looking after both, that is worth pausing on.

A transplant is a treatment, not an event. Immunosuppressive medication continues indefinitely, doses are adjusted, and blood tests track both the graft and the drugs.

So: which clinician at home will supervise that, what will the centre send them, and is the medication available and affordable where you live? A transplant that succeeds in theatre and fails eighteen months later for want of accessible medication is a foreseeable outcome — and it is foreseeable now.