 Hi, I'm Dr. Gautam Kumar. I'm the Consentant Liver Transplant and Hepatobiliary Surgeon here at Manipal Group of Hospital Spangler. The liver transplantation is a very complicated procedure involving two surgeries. It requires a lot of medications, a lot of equipment, a lot of sutures which are pretty expensive. The cost of liver transplantation is high because of that. We in India still do cheaper liver transplantation, about 5 to 10 times cheaper than that in USA and around 3 to 4 times cheaper than that in Singapore. So we still are very cost effective doing liver transplantation. Other thing I need to emphasize upon is how cost effective is liver transplantation when compared to medical therapy. A medical therapy 3 time admission per year is probably more costly than a liver transplantation with bad quality of life. So on the long run I feel liver transplantation is not that costly.