Since the mid 1990s, transplantation knowledge and techniques, as well as insights into pharmacology, have improved, thus enabling greater access to transplantation for patients. The pool of organs for transplantation is stable, and therefore insufficient to cope with the growing demand. To adjust demand and resources in the most equitable way, organ procurement and allocation have been organized nationally and often across borders. The national and international organ exchange programmes were studied and discussed during the Congress on Organ Allocation, from which this book is derived. This book describes the state of the art in the management of waiting lists and the allocation of organs in transplantation. It includes chapters on the possibilities of expanding the pool of available cadaver organs. It also analyzes the results of transplantation of cadaver organs from older donors and marginal, non-heart-beating donors. Transplantation policies based on the offering of organs by living donors are also described, as is the impact of delayed graft function on organ allocation.

This text is part of the Continuing Education series, organized by Fondation Marcel Merieux and Universite Claude Bernard in Lyon where the annual subject is chosen to reflect the status of the topical issues of the year, as taught by leading international experts. The contribution of transplantation and clinical immunology to advanced medicine is considerable and promising. The annual volumes in this series keep the reader abreast of these developments in the field.

With a long practice of organ transplantation, retransplantation has become a major goal in patients with long-term failure of their first transplant (chronic rejection, exhaustion of the transplant, recurrence of the initial disease, etc. ). In addition, retransplantation can be necessary in the initial period, due to severe acute rejection, a non-functioning organ, or surgical complication. Immunological and non-immunological factors affecting the success of a second transplant are described in this volume, together with alternatives to retransplantation. It is hoped that in the future retransplants will be less frequent, as a result of improved prevention of transplant failure. J. L. Torrroine et a/. (ens. ), Retra isplantation, xvii. Q 1997 Kluwer Academic Pirblislters. P . iilted in Great Britain. List of contributors R. ARNOLD Y. W. CHO University of Pittsburgh UCLA School of Medicine Center for Medical Ethics Tissue Typing Laboratory Division of General Internal Medicine 950 Veteran Avenue 200 Lothrop Street - MUH, Suite W-919 Los Angeles, CA 90095-1652 Pittsburgh, PA 15213-2582 USA USA P. COCHAT M. A. BELGER Hopital Edouard Herriot UKTSSA Pavillon S Fox Den Road 5, Place d'Arsonva1 Stoke Gifford F-69437 Lyon Cedex 3 Bristol BS12 5RR France UK B. CUZIN F. BERTHOUX Hopital Edouard Herriot Service de Nephrologie et Pavillon V Transplantation Renale 5, Place d3Arsonval Hopital Nord F-69437 Lyon Cedex 3 F-42055 Saint Etienne Cedex 2 France France J. H. DAUBER C.

In all varieties of organ transplants, early results have dramatically improved over the past two decades and failures due to acute rejection are becoming rarer. Efficient immunosuppressive regimens have been developed with the objective of very good results at 1, 3 and 5 years. Successful transplants, however, are significantly less frequent at 10 and 20 years, and many patients require retransplantation. Many factors are involved in late graft loss and it is now well recognized that, in addition to chronic rejection, a number of non-immunologic factors play a prominent role. In the case of renal transplantation, a reduced mass loss (transplantation of a single kidney, sometimes from an aged donor, ischemic injury and alteration of some nephrons in the case of early acute rejection) will result in slowly progressing chronic renal failure, even in the absence of any supplementary attack of an immunological nature. The new treatments must be analyzed in the light of their capacity to reduce these late failures. Several preventive measures can also limit both immunologic and non-immunologic factors of late transplant deterioration.

In this sequel to A Critique of Modernity, Alain Touraine questions the social and cultural content of democracy today. At a time when state power is being increasingly eroded by the economic might of transnational capital, what possible value can we ascribe to a democratic idea that is defined merely as a set of guarantees against the totalitarian

Although the period of student protests of the 1960s and 1970s has long passed, Alain Touraine argues, in this wide-ranging and vigorous essay, that the period's problems remain with us. Higher degrees have become less and less valuable on the labor market and the demand for academic reform has become more intense. Community colleges still try to provide equal educational opportunities for the poor and the minorities, without much success. And the university has not yet resolved the conflict between being the home of impartial inquiry and research and serving constituent interests. Touraine views American higher education as a system within a definite, though changing, social context. He compares U.S. student movements with those of other countries. He is skeptical about the way Americans view the relationships between the university and what he regards as the ruling forces of the society, between knowledge and power, between production and education. He offers no facile solutions, but he presents an exciting, nontraditional analysis of the social and political forces that have shaped the modern history of higher education. In the new introduction, Clark Kerr contrasts his own views as an American observer to those of Touraine as a French intellectual. He asserts that the family, not higher education, is the most important "school" in the process of reproducing society. Kerr places more emphasis than does Touraine on the labor market, on the production functions (training of skills and advancing technology) of the vast nonelite segments of American higher education, on the long-term impacts of science in changing society, and on scholarly criticism in affecting transformations, and places less emphasis on sporadic political protests by faculty and students. He agrees with Touraine however, in his two great themes: (1) that you cannot understand the academic system unless you first understand society; and (2) that the rise of the university must be understood to understand modern society, where "knowledge is power." This volume will be important to all those interested in higher education, whether as participants or observers.

This title was first published in 2003. The "Red Mafia" in Russia have become the subject of increasing international interest and considerable misinterpretation. After well-received editions in Russian, French and Italian, Anton Oleinik's study of Russian prisons, in which he explores the social roots of organized crime in post-Soviet societies, is now published in English. This English edition includes a postscript on the Moscow terrorist crisis of 2002. Oleinik's analysis reveals prison society as a mirror of broader Russian society - characterized by the absence of the state as an organizer of social practices. He builds on this to make a central distinction between two types of societies - the modern "large" society and the "small" society, like Russia, that has only been partially modernized, and in which the world of everyday life, experiences and relationships remains entirely separated from the official aims of modernization and efficiency. Oleinik is interested in the void between these two separate worlds, a void he sees being filled in Russia by the Mafia.

Although the period of student protests of the 1960s and 1970s has long passed, Alain Touraine argues, in this wide-ranging and vigorous essay, that the period's problems remain with us. Higher degrees have become less and less valuable on the labor market and the demand for academic reform has become more intense. Community colleges still try to provide equal educational opportunities for the poor and the minorities, without much success. And the university has not yet resolved the conflict between being the home of impartial inquiry and research and serving constituent interests.

Touraine views American higher education as a system within a definite, though changing, social context. He compares U.S. student movements with those of other countries. He is skeptical about the way Americans view the relationships between the university and what he regards as the ruling forces of the society, between knowledge and power, between production and education. He offers no facile solutions, but he presents an exciting, nontraditional analysis of the social and political forces that have shaped the modern history of higher education.

In the new introduction, Clark Kerr contrasts his own views as an American observer to those of Touraine as a French intellectual. He asserts that the family, not higher education, is the most important "school" in the process of reproducing society. Kerr places more emphasis than does Touraine on the labor market, on the production functions (training of skills and advancing technology) of the vast nonelite segments of American higher education, on the long-term impacts of science in changing society, and on scholarly criticism in affecting transformations, and places less emphasis on sporadic political protests by faculty and students.

He agrees with Touraine however, in his two great themes: (1) that you cannot understand the academic system unless you first understand society; and (2) that the rise of the university must be understood to understand modern society, where "knowledge is power." This volume will be important to all those interested in higher education, whether as participants or observers.

This title was first published in 2003. The "Red Mafia" in Russia have become the subject of increasing international interest and considerable misinterpretation. After well-received editions in Russian, French and Italian, Anton Oleinik's study of Russian prisons, in which he explores the social roots of organized crime in post-Soviet societies, is now published in English. This English edition includes a postscript on the Moscow terrorist crisis of 2002. Oleinik's analysis reveals prison society as a mirror of broader Russian society - characterized by the absence of the state as an organizer of social practices. He builds on this to make a central distinction between two types of societies - the modern "large" society and the "small" society, like Russia, that has only been partially modernized, and in which the world of everyday life, experiences and relationships remains entirely separated from the official aims of modernization and efficiency. Oleinik is interested in the void between these two separate worlds, a void he sees being filled in Russia by the Mafia.

What effects will the current economic crisis have on the long-term development of our societies? What does the future hold in store when we emerge from the crisis? These two questions lie at the heart of this important new book by the leading French sociologist Alain Touraine. In an era dominated by the global economy and the triumph of individualism, our society has broken away from the old model of integration in place since the industrial revolution. We no longer see ourselves as players in an economic system around which every aspect of society is ordered but rather as individuals with our own rights, capable of creating our own lives in a world in which cultural values prevail. The financial crisis and the growing autonomy of speculative and financial imperatives have exacerbated the rift between the economy and society and could push this long-term tendency in either of two directions. On the one hand, individuals who find themselves unemployed, impoverished and stripped of their savings may feel increasingly excluded and incapable of reacting politically, which would explain the silence of many victims of the crisis. On the other hand, individuals could also find themselves transformed into social actors who are defined increasingly in moral and universal terms, in which case the crisis could help to precipitate a long-term cultural evolution. We are facing a future as yet undecided, a future hovering between catastrophe and radical reform. This book explores the factors that could tip the balance.

Rejection and Tolerance is the latest subject in the Continuing Education series, organized by Fondation Marcel Merieux and Universite Claude Bernard in Lyon. The annual subject is chosen to reflect the status of the topical issues of the year, as taught by leading international experts. The contribution of transplantation and clinical immunology to advanced medicine is considerable and promising. The annual volumes in this series keep the reader abreast of these developments. "

Today neoliberals argue that we should let ourselves be guided by market forces and that there is little we can do to stem the flow of economic globalization. On the other hand, thinkers on the left continue to denounce domination and claim to speak in the name of victims who are powerless to change the circumstances of their lives. Despite the differences between these two political positions, they suffer from a common weakness: they underestimate the role of autonomous social actors who are capable of influencing political decision-making.

In this important new book Alain Touraine - the leading sociologist and social theorist - attacks the positions of the neoliberals and certain thinkers on the left and develops an alternative view of the tasks for political thought and action today. He argues that the globalization of the economy has not dissolved our capacity for political action, and that the actions of the most underprivileged sections of society are not restricted to rebellion against domination: they can also demand rights (in particular, cultural rights), and can therefore put forward an innovative and not merely critical conception of society and its future.

"Beyond Neoliberalism" is an original and timely contribution to current debates about the changing nature and goals of politics in our contemporary, globalized age. It will be of great interest to students of politics and sociology and will also appeal to a broader readership interested in contemporary politics and current affairs.

With a long practice of organ transplantation, retransplantation has become a major goal in patients with long-term failure of their first transplant (chronic rejection, exhaustion of the transplant, recurrence of the initial disease, etc. ). In addition, retransplantation can be necessary in the initial period, due to severe acute rejection, a non-functioning organ, or surgical complication. Immunological and non-immunological factors affecting the success of a second transplant are described in this volume, together with alternatives to retransplantation. It is hoped that in the future retransplants will be less frequent, as a result of improved prevention of transplant failure. J. L. Torrroine et a/. (ens. ), Retra isplantation, xvii. Q 1997 Kluwer Academic Pirblislters. P . iilted in Great Britain. List of contributors R. ARNOLD Y. W. CHO University of Pittsburgh UCLA School of Medicine Center for Medical Ethics Tissue Typing Laboratory Division of General Internal Medicine 950 Veteran Avenue 200 Lothrop Street - MUH, Suite W-919 Los Angeles, CA 90095-1652 Pittsburgh, PA 15213-2582 USA USA P. COCHAT M. A. BELGER Hopital Edouard Herriot UKTSSA Pavillon S Fox Den Road 5, Place d'Arsonva1 Stoke Gifford F-69437 Lyon Cedex 3 Bristol BS12 5RR France UK B. CUZIN F. BERTHOUX Hopital Edouard Herriot Service de Nephrologie et Pavillon V Transplantation Renale 5, Place d3Arsonval Hopital Nord F-69437 Lyon Cedex 3 F-42055 Saint Etienne Cedex 2 France France J. H. DAUBER C.

Over the last few years, transplantation knowledge and techniques, as well as insights into pharmacology, have improved, thus enabling greater access to transplantation for patients. The pool of organs for transplantation is stable, and therefore insufficient to cope with the growing demand. To adjust demand and resources in the most equitable way, organ procurement and allocation have been organized nationally and often across borders. The national and international organ exchange programs were studied and discussed during the Congress on Organ Allocation, from which this book is derived. This book describes the state of the art in the management of waiting lists and the allocation of organs in transplantation. It includes chapters on the possibilities of expanding the pool of available cadaver organs. It also analyzes the results of transplantation of cadaver organs from older donors and marginal, non-heart beating donors. Transplantation policies based on the offering of organs by living donors are also described, as is the impact of delayed graft function on organ allocation.

Organ Shortage: The Solutions is the latest subject in the Continuing Education series, organized by Fondation Marcel Merieux and Universite Claude Bernard in Lyon. The annual subject is chosen to reflect the status of the topical issues of the year, as taught by leading international experts. The contribution of transplantation and clinical immunology to advanced medicine is considerable and promising. The annual volumes in this series keep the reader abreast of these developments. "

In all varieties of organ transplants, early results have dramatically improved over the past two decades and failures due to acute rejection are becoming rarer. Efficient immunosuppressive regimens have been developed with the objective of very good results at 1, 3 and 5 years. Successful transplants, however, are significantly less frequent at 10 and 20 years, and many patients require retransplantation. Many factors are involved in late graft loss and it is now well recognized that, in addition to chronic rejection, a number of non-immunologic factors play a prominent role. In the case of renal transplantation, a reduced mass loss (transplantation of a single kidney, sometimes from an aged donor, ischemic injury and alteration of some nephrons in the case of early acute rejection) will result in slowly progressing chronic renal failure, even in the absence of any supplementary attack of an immunological nature. The new treatments must be analyzed in the light of their capacity to reduce these late failures. Several preventive measures can also limit both immunologic and non-immunologic factors of late transplant deterioration.

Malignancies are frequent complications in organ transplantation, mainly as the result of infection with certain viruses and of long-term immunosuppression. The epidemiology confirms that the increased incidence concerns certain cancers, especially HIV-related skin cancers and EBV-related lymphoproliferative malignancies. This book covers all currently available information on this important topic of the relationships between transplantation and malignancies: preexisting cancers, posttransplant cancers, their etiology and pathophysiology, their prevention and treatment. A significant part of the volume is devoted to prophylaxis, early detection and modern forms of therapy in posttransplant lymphomas. As a conclusion of all these new data, the theory of immunosurveillance deserves to be significantly modified.

In this book, a leading French social thinker grapples with the gap between the tendency toward globalization of economic relations and mass culture and the increasingly sectarian nature of our social identities as members of ethnic, religious, or national groups. Though at first glance, it might seem as if the answer to the question "Can we live together?" is that we already do live together--watching the same television programs, buying the same clothes, and even using the same language to communicate from one country to another--the author argues that in important ways, we are farther than ever from belonging to the same society or the same culture.
Our small societies are not gradually merging into one vast global society; instead, the simultaneously political, territorial, and cultural entities that we once called societies or countries are breaking up before our eyes in the wake of ethnic, political, and religious conflict. The result is that we live together only to the extent that we make the same gestures and use the same objects--we do not communicate with one another in a meaningful way or govern ourselves together.
What power can now reconcile a transnational economy with the disturbing reality of introverted communities? The author argues against the idea that all we can do is agree on some social rules of mutual tolerance and respect for personal freedom, and forgo the attempt to forge deeper bonds. He argues instead that we can use a focus on the personal life-project--the construction of an active self or "subject"--ultimately to form meaningful social and political institutions.
The book concludes by exploring how social institutions might be retooled to safeguard the development of the personal subject and communication between subjects, and by sketching out what these new social institutions might look like in terms of social relations, politics, and education.

In this book, a leading French social thinker grapples with the gap between the tendency toward globalization of economic relations and mass culture and the increasingly sectarian nature of our social identities as members of ethnic, religious, or national groups. Though at first glance, it might seem as if the answer to the question "Can we live together?" is that we already do live together--watching the same television programs, buying the same clothes, and even using the same language to communicate from one country to another--the author argues that in important ways, we are farther than ever from belonging to the same society or the same culture.
Our small societies are not gradually merging into one vast global society; instead, the simultaneously political, territorial, and cultural entities that we once called societies or countries are breaking up before our eyes in the wake of ethnic, political, and religious conflict. The result is that we live together only to the extent that we make the same gestures and use the same objects--we do not communicate with one another in a meaningful way or govern ourselves together.
What power can now reconcile a transnational economy with the disturbing reality of introverted communities? The author argues against the idea that all we can do is agree on some social rules of mutual tolerance and respect for personal freedom, and forgo the attempt to forge deeper bonds. He argues instead that we can use a focus on the personal life-project--the construction of an active self or "subject"--ultimately to form meaningful social and political institutions.
The book concludes by exploring how social institutions might be retooled to safeguard the development of the personal subject and communication between subjects, and by sketching out what these new social institutions might look like in terms of social relations, politics, and education.

In this sequel to "A Critique of Modernity, " Alain Touraine questions the social and cultural content of democracy today. At a time when state power is being increasingly eroded by the economic might of transnational capital, what possible value can we ascribe to a democratic idea that is defined merely as a set of guarantees against the totalitarian state?If democracy is to survive in the postcommunist world, Touraine argues, it must accomplish two urgent goals: It must somehow protect the power of the nation-state at the same time as it limits that power (for only the state has sufficient means to counterbalance the global corporate wielders of money and information); and it must reconcile social diversity with social unity and individual liberty with integration.This is not merely a philosophical problem but a dilemma whose resolution will dramatically affect the immediate future of people everywhere. If we want a resolution in democracy's favor, then it is time, in Touraine's view, for us to redefine democracy in terms of active intervention rather than mere passive institution. To preserve the power and effectiveness of our states and societies, we must make visible strides--and soon--away from a politics of particularity and toward the integration and balancing of women and minorities, of immigrants, of rich and poor. If our states become too weakened, too debased by the politics of competing identities and interest groups, we will one day find ourselves without the means to protect the very values we believe we are fighting to uphold.

In this provocative and timely new book, Alain Touraine explores the question of how we might live together in a truly globalized world society. Rejecting the seductive metaphor of a global melting pot, Touraine mounts a powerful attack on the idea that we now live together as equals, sharing the same social and cultural values. If anything, he argues, our differences are being heightened, as communities increasingly define their identities against the encroaching forces of globalization.

Touraine argues that the twin processes of globalization and particularization are pushing us further and further apart. On the one hand, traditional values and forms of cultural expression are being eroded by homogenized mass culture. On the other, communities are becoming more introverted as they fight to defend themselves from outside influences. Even the cities where our global networks originate and are controlled are made up of communities which are foreign to one another, as they defend their identities from the tokens of mass culture.

How do we avoid a global conflict between those who control the international networks of information, and those who feel threatened by them? The first part of Touraine's book asserts that the only way to prevent the destruction of identity is for individuals to develop a personal life-project, which he calls the 'Subject'. To become a subject, the individual constructs itself as an actor, forming a stable point of reference in a world of permanent and uncontrollable change. In the second part of the book, Touraine examines how this apparently non-social principle might be used to reconstruct social life. The first step is to recognize that others arealso subjects, striving for a sense of personal freedom. Touraine then argues for a replacement of the old idea of democracy, defined as participation in the general will, with the new idea of institutions that safeguard the freedom of the subject and permit communication between subjects. This is the only approach that will allow us to live together, equal and different.

This book will be of great interest to second- and third-year undergraduates and graduate students of sociology and politics.

In his previous books Alain Touraine analysed the great changes that have transformed our personal and collective lives; in this new book he shows that we need to transform our ways of thinking about these changes. The very idea of society is in crisis: globalization and the liberation of desires from taboos have led to the collapse of the old social order. In our societies today, good and evil can no longer be defined by institutions; self-awareness is more important than the awareness of rules and subjects have become their own creators. Taking as his starting point a critique of what he calls the Dominant Interpretive Discourse, which tried throughout the twentieth century to impose the idea of a society without actors that was subject to various kinds of determinism (especially economic determinism), Touraine argues that the only principle that allows us to evaluate individual behaviour and social situations is the recognition of the political, social and cultural rights of all human beings, who are viewed as free and equal. The individual must be seen as a subject and treated as the cornerstone of a reconstructed sociology. Whereas some denounce individualism, the author celebrates a subjectivation that involves the defence of the rights of all against all modes of social integration. This general line of argument is made concrete through an analysis of the subordination of women, the exclusion of minorities and the difficulties young people face at school and at work. This major new book represents in many ways the culmination of twenty years of theoretical reflection which began with Critique of Modernity and which have established Touraine as one of the leading figures of contemporary social thought.