Criteria for evaluating potential transplant recipients vary among centers, physicians

Article Abstract:

Criteria used in selecting patients eligible for kidney transplantation appear to vary among transplant physicians and transplantation centers. One study of 182 transplantation centers found that, in general, university-based centers tend to perform more transplants and to accept patients more readily than private centers. One of the most important factors in selection among physicians is patient compliance. Most physicians surveyed felt that non-compliance with medical instructions, dialysis, and use of medications was cause to refuse transplantation. Furthermore, 62% of the physicians viewed a history of alcohol or drug abuse as non-compliance. Other factors physicians and centers consider in selecting patients include advanced age, heart disease and infection with hepatitis C. Representatives from only 24% of the centers surveyed said that the present organ allocation system is fair and equitable. Most felt that it could be improved by emphasizing tissue matching and widening the distribution of organs.

Management, Kidneys, Kidney transplantation, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation

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United States loses lead in contraceptive choices, R&D; changes in tort liability, FDA review urged

Article Abstract:

The United States lags behind other countries in contraceptive research and development. Only one new contraceptive method, Norplant, has been introduced since the 1960's. The risk of laws suits and high liability insurance premiums are considered the most important barrier to research. AH Robbins Co, manufacturer of an intrauterine device (IUD), was forced into bankruptcy after paying over $250 million in damages. Nine companies had been conducting contraceptive research in the 1960's. Now only one, Ortho Pharmaceutical Corp, has any important research and development programs. The Food and Drug Administration's (FDA) approval process should be changed to consider the risk of pregnancy and childbirth against the risk and benefit of a proposed new technique. Contraceptives with few side effects but high failure rates are not always safer. Women under 35 years old who do not use contraceptives have higher mortality rates than women who smoke and use the birth control pill.

Product development, Laws, regulations and rules, Medical research, Contraceptives

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