Doctor Willem Kolff: Physician who invented artificial hearts and kidneys
Wednesday 29 April 2009
Willem Kolff, who was known to friends and colleagues as Pim, was the father of artificial organs. He invented the first artificial kidney (blood dialysis) machine, pioneered blood transfusion in Europe, invented the heart-lung machine and co-invented the Jarvik artificial heart.
Kolff was born in Leiden, the Netherlands, in 1911, the son of a doctor who supervised a tuberculosis sanatorium. Despite dyslexia, he studied medicine in his home town, where he worked as a pathology assistant before graduating in 1938. He did his postgraduate training in Groningen. It was an unpaid job but he was supported by his wife, Janke, whom he had married the year before. One of Kolff's first patients was a 22-year-old with a kidney infection which prevented him from excreting urea, which is poisonous in high concentrations. Kolff realised that such a patient would live if the urea could be removed until the kidneys recovered.
Seeing that war in Europe would necessitate the availability of blood transfusion, which had been pioneered in Britain, in 1940 Kolff organised the first blood bank on the continent. That year Germany invaded the Netherlands. Kolff moved to the small town of Kampen, where he risked his life helping Jews and members of the resistance movement, hiding, at various times, up to 800 people in his hospital, sometimes helping them to feign terminal illness to escape the attentions of the Nazi occupiers.
In 1943 he developed a kidney machine after experiments using blood contained in commercial sausage-skin – which allows minerals to diffuse through it – immersed in a bath of salts resembling those found in blood. He wrote: "I found that in five minutes nearly all the urea I had added to the blood sample, 400 milligrams of it, had disappeared from the blood and had entered the saline bath."
Fourteen of the first 15 patients on whom he used the technique died, and the survivor might have lived in any event. The first patient whose life Kolff undoubtedly saved was a 67-year-old woman, Maria Sofia Schafstadt, who had been imprisoned as a Nazi collaborator. She lived for a further seven years.
In 1946 Groningen university awarded Kolff a PhD and that year he published his first book, The Artificial Kidney, in Dutch and English. A year later came a second book, on the treatment of uraemia. Kolff did not patent his machine but he did construct machines for researchers in the UK, America and Canada.
During the following four years Kolff often visited America and in 1950 he moved to the Cleveland Clinic in Ohio, a centre of excellence for cardiac surgery. Here he had to learn English and retake his medical examinations. He assembled a team that in 1955 developed the pump-oxygenator – a heart-lung machine – which takes over the patient's breathing and blood-pumping during cardiac surgery. He and his team also produced the first aortic balloon pump, which increases the heart's output in cases of cardiogenic shock. It is still widely used in emergency medicine.
In the mid-1950s the American Society for Artificial Internal Organs broached the idea of an artificial heart. Once regarded as taboo, it soon became a respectable research area. In 1957 Kolff and his team tried an air-driven pump to drive circulation in a dog, which lived for 90 minutes. He tried several other technologies before settling on a silicone-rubber heart that ran on compressed air.
He was still engaged on this project in 1967 when he moved to the University of Utah's division of artificial organs and Institute for Biomedical Engineering, where he led a team of 175. He contributed to the design of the Jarvik heart, which he named after his main collaborator. The world's first successful artificial heart, in 1982 it was implanted into a terminally-ill retired dentist, Barney Clark, who lived on for 112 days. Later, Kolff and his colleagues tried to develop artificial eyes and ears and improved the function of artificial limbs.
Kolff formally retired when he was 86, but he continued writing. He wrote more than 500 papers and articles – the most recent in 2007, when he was 96 – and several more books. He was awarded a dozen honorary degrees by universities around the world and was nominated for a Nobel Prize in 2003, having won an Albert Lasker Award, an "American Nobel", in 2002.
Despite his courtesy and charm, his devotion to work probably led to Janke divorcing him when he was 89. He spent his last years in a care home, where he declined the lampshade-making on offer and used the craft room to model a new heart pump.
Dr Willem Johan Kolff, physician: born Leiden, Netherlands 14 February 1911; clinical assistant Groningen University, physician, Kampen Hospital, Cleveland Clinic Ohio 1950-67; head of artificial organs division, University of Utah 1967-96; married 1937 Janke Huidekoper (divorced 2000, deceased 2006, four sons, one daughter); died Newtown Square, Pennsylvania 11 February 2009.
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