The outcome, cost, length of hospital stay, and extent of rehabilitation were assessed in a series of 55 consecutive patients who received hepatic transplants between May 1982 and June 1985. In the same geographic region, medical costs for patients dying of hepatic failure without transplantation were studied for years 1979 through 1984. One-yr survival in all patients transplanted without cancer was 71%, and the mean cost was $92,866. The mean cost of hospitalization for the last 12 months of life in patients who did not receive transplants was $45,643. Eight-two percent of patients surviving the first yr are fully rehabilitated and restored to pre-illness activity. Length of hospital stay, hospital costs, and the extent of rehabilitation closely correlate with a grading system based on preoperative medical status. We conclude that hepatic transplantation restores high-quality, useful life to patients with endstage liver disease in a predictable and cost-effective manner.