title: Face transplantation program in France: a cost analysis of five patients.
abstract: BACKGROUND
  Among 18 face transplantations (FTs) performed worldwide, seven were performed at the Henri Mondor Hospital, Paris, France. Their feasibility and risk-benefit ratios have been reported, whereas this study analyzed the costs of FT for our first five patients.
  
  
  METHODS
  The first five FT patients transplanted at the Henri Mondor Hospital presented disfigurements due to neurofibromatosis, severe burns, or ballistic trauma and had no relevant comorbidity. All were socially isolated and unemployed. We analyzed the costs of preoperative investigations, operative procedures, and hospitalization for each patient. A public research program (PHRC) financed the procedures, and the clinical research department refunded each FT's cost. To allow comparisons between health care systems, the cost of FT was compared with the mean costs of heart, liver, and kidney transplantations performed at the same institution.
  
  
  RESULTS
  If all the five patients survived the FT procedure, one patient died during subsequent revisions procedures for sepsis. The overall costs for the operation and its subsequent hospitalization for each patient ranged from (20AC)103,108 to (20AC)170,071, depending on the transplant required, the technical pitfalls, the outcomes, and mainly postoperative intensive cares.
  
  
  CONCLUSIONS
  In our institution, the transplantation of a face led to higher costs than heart or any other solid organ and represented twice the costs faced for a liver transplantation. FT is currently performed in a research setting, and cost might decrease with teams' experiences, which may shorten postoperative intensive care and overall hospital stays.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Est Créteil-UPEC, Créteil, France. evarueegg@hotmail.com
authors.forename: Eva Meia
authors.initials: EM
authors.lastname: Rüegg
authors.forename: Mikael
authors.initials: M
authors.lastname: Hivelin
authors.forename: François
authors.initials: F
authors.lastname: Hemery
authors.forename: Colin
authors.initials: C
authors.lastname: Maciver
authors.forename: Marc David
authors.initials: MD
authors.lastname: Benjoar
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Meningaud
authors.forename: Laurent
authors.initials: L
authors.lastname: Lantieri
mesh_terms: D000328:Adult; D002056:Burns / Q000601:surgery; D005151:Facial Injuries / Q000601:surgery; D005153:Facial Neoplasms / Q000601:surgery; D054445:Facial Transplantation / Q000191:economics* / Q000401:mortality; D005602:France; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D009456:Neurofibromatosis 1 / Q000601:surgery; D016377:Organ Transplantation / Q000191:economics; D016896:Treatment Outcome