OBJECTIVE: The purpose of this study was to analyse the cost-utility ratios of liver and kidney transplantations in a German transplant centre. METHOD: 60 patients with liver transplantation and 77 patients with kidney transplantation were included in a full cost assessment based on process costs with different cost drivers (e.g. patient days, dialysis treatments, admission) and based on the friction cost method to calculate indirect costs. Benefits of transplantation were assessed employing the EuroQol quality of life instrument (German version). Both costs and benefits were discounted with a discount rate of 5 %. Several sensitivity analyses were performed. RESULTS: Discounted with 5 % and with a time horizon of 20 years dialysis patients could gain 0.76 quality adjusted life years (QALYs). Liver transplant recipients gained 3.85 QALYs. The cost per QALYs gained ratio is 76,800 DM for liver transplantation. Gross cost per QALY of dialysis patients is 147,800 DM (kidney transplantation: 38,300 DM). Liver patients have a higher potential to experience a significant gain in quality of life than dialysis patients. On the other hand the long-term results of patients who received a kidney transplantation are better in terms of mortality compared to patients who received a liver transplantation. Nevertheless, patients with liver transplantation experience higher numbers of QALYs gained than patients with kidney transplantation, as the mortality of dialysis patients does not change after transplantation (except for the operation risk). CONCLUSION: Liver transplantation is still a high-cost procedure with a high cost-utility ratio compared to other medical interventions. To avoid problems of financing the cost of liver transplantation have to be decreased and / or outcomes (mortality, quality of life) must be improved. “ECONOMIC & OUTCOMES ISSUES OF PAIN MANAGEMENT”