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Paul S. Russell, MD

JAMA. 1999;281:1431-1432.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Intense concern regarding the mounting expense of health care has naturally prompted special attention to expensive treatments and those devoted to the care of relatively few patients. Liver transplantation exemplifies both of these characteristics. In this issue of THE JOURNAL, Showstack and colleagues¹ present an analysis of important variables that contribute to the high cost of liver transplantation. Resource use and costs were examined at 3 participating institutions, and these were related to certain risk factors and practices.

Liver transplantation is expensive, with an average cost of $203,434 for the operation and the first year's continuing care thereafter at these 3 institutions. The procedure is also a remarkably effective treatment as it rescues from a terminal or preterminal state approximately 90% of patients who undergo it.² It is this combination that makes the problem poignant: high cost combined with a good outcome for a procedure provided . . . [Full Text of this Article]

Author Affiliation: Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston.

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