Living-donor liver transplants cap surgical research for decade of 1980s

Article Abstract:

The major surgical advances of the 1980s were capped by the first transplant of a liver removed from a living parent-donor into their dying child. Although segments of livers from living donors have been transplanted on an emergency basis into recipients who were dying, this is the first case of living-donor surgery within the United States. The child in this first living transplant was selected because she had not yet begun the expected regression which occurs to children who have biliary atresia, a lack of development of the liver's duct system. The transplant operation is possible because the liver is capable of rapid regeneration which occurs both in the transplanted segmented and in the remaining liver (within the donor). This surgery was carried out by Chicago surgeon Christopher E. Broelsch at the University of Chicago Wyler Children's Hospital on December 8, 1989. Although the surgery was relatively straightforward, Broelsch experienced difficulty with the extreme fragility and softness of the fresh liver tissue. This caused difficulty in shaping the liver, placing surgical sutures, and controlling bleeding. The bleeding difficulties continued and additional surgery proved necessary. The donor, the child's mother, also experienced a minor setback which resulted from the loss of a unit of blood and required the removal of her spleen when a surgical retractor slipped during the surgical procedure. The use of tissues from a related party greatly reduces the difficulties of graft versus host reaction (tissue rejection) which usually accompanies the transplantation of foreign, incompletely matched tissue. Although many support living-donor surgery, some physicians believe that it is unnecessary and potentially too dangerous to the donor.

Research, Case studies, Surgery, Liver, Liver transplantation, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Organ donors, Tissue donors, Biliary atresia

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Gun-associated violence increasingly viewed as public health challenge

Article Abstract:

Public health experts believe that a scientific approach should be taken towards reducing the number of gun-related injuries. In Nov 1991, a graduate student shot six people on a University of Iowa campus in Iowa City with a legally purchased handgun. The University of Iowa Injury Prevention Research Center held a conference on handgun injuries in response to this incident. At the conference, public health experts discussed methods to prevent or reduce the number of gun-associated deaths and injuries. Gun-associated injuries are the eighth leading cause of death in the US, and handguns are used in two-thirds of all firearm-related deaths. The cost per person of firearm-related fatalities is the highest of any injury-related death. Individuals who buy guns for self-protection often use them to commit suicide or against friends and family, rather than against intruders. The number of handgun-associated deaths in Vancouver, British Columbia, a city with strict gun-control laws, is five times less than in Seattle.

Health aspects, Prevention, Firearms, Violence

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Clinton tinkers with health system status quo; critics seek to pick apart managed competition

Article Abstract:

The Clinton administration plans to submit a health care reform package to Congress by May 1993. The plan would provide universal health care for US citizens and would control health care expenses. Bill Clinton announced no new cuts in the Medicare system in his State of the Union address, but payments to Medicare physicians and hospitals will not be increased as much as planned. Managed competition is a plan for health care reform favored with reservations by Clinton. This plan would involve health insurance purchasing cooperatives that bargain for universal health care coverage. Critics believe that managed competition will not control health care costs. Many individuals believe that prices associated with health care need to be reduced to reduce health care costs. Another criticism is that managed competition does not emphasize primary care or prevention.

Planning, Clinton, Bill, Social policy, Health care reform

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