I liked Janeway in this one. She demonstrates confidence and strength whilst still being emotionally effected by events. The writers would later forget how to combine these two traits. The first chance for the Doctor to be looked at as a character. Truth be told, he seemed too developed at such an early point (it's basically the doctor we know and love) I would have preferred him to be a little more blank and for his personality to grow but it's pretty much there from the off
I dislike the whole harvesting organs thing and like you, find it perplexing that they have technology that can do so much yet apparently can't create artificial organs. The Frankenstein monster stuff lacks subtlety and having Dureth and Motura speak like creepy butlers from a 50's horror movie bothered me.
The less said about Neelix and his Ocampan lung the better
I know a lot of people like the Vidians as a species but I always thought they were equally as unimpressive as the Kazon quite honestly. Sure, they're more developed than the Kazon but a piece of bread with two eyes drawn on it is also more developed than the Kazon