February 13, 2009
Willem Kolff, Inventor of Kidney and Heart Machines, Dies at 97By SANDRA BLAKESLEE
New York Times
Dr. Willem J. Kolff, a Dutch physician who invented the first artificial kidney in a rural hospital during World War II and went on to prove that biomedical engineers could build all sorts of artificial organs for keeping patients alive, including the first artificial heart, died Wednesday at his home in Newtown Square, Pa. He was 97.
His death was announced by the University of Utah in Salt Lake City, where Dr. Kolff was distinguished professor emeritus of bioengineering, surgery and medicine. He died of natural causes, his son Therus added.
Dr. Kolff, who immigrated to the United States in 1950, was widely regarded as the father of artificial organs. His artificial kidney, which evolved into modern dialysis machines for cleansing the blood of people whose kidneys have failed, has saved millions of lives.
His membrane oxygenator, which provided a way to add oxygen to blood as it passed through a machine, is still used in heart-lung machines during open heart surgery. His artificial heart — though it carried the name of a colleague, Dr. Robert Jarvik — was first implanted into a person, a 61-year-old retired dentist named Dr. Barney Clark, in December 1982.
Dr. Kolff’s policy was to attach the name of the co-worker currently working on any particular model of artificial heart, according to Dr. Kolff’s biographer, Herman Broers, in the book “Inventor for Life” (B & V Media Publishers, 2007). When it came time to implant a heart into a patient, he said, the Jarvik-7 was chosen because it had a multilayer diaphragm, designed by Dr. Jarvik, that proved crucial to the device’s success. But credit for the artificial heart belongs to Dr. Kolff.
As a young physician at the University of Groningen in the Netherlands in 1938, Dr. Kolff watched a young man die a slow, agonizing death from temporary kidney failure. He reasoned that if he could find a way to remove the toxic waste products that build up in the blood of such patients, he could keep them alive until their kidneys rebounded.
For his first experiment, Dr. Kolff filled sausage casings with blood, expelled the air, added a kidney waste product called urea and agitated the contraption in a bath of salt water. The casings were semipermeable. Small molecules of urea could pass through the membrane while larger blood molecules might not.
In five minutes, all the urea had moved into the salt water. The concept for building an artificial kidney was born but soon went underground.
In May 1940, Germany invaded the Netherlands. Rather than cooperate with Nazi sympathizers put in charge at Groningen, Dr. Kolff moved to a small hospital in Kampen, on the Zuider Zee (now called the Ijsselmeer), to wait out the war. While there, he set up Europe’s first blood bank and saved more than 800 people from Nazi labor camps by hiding them in his hospital. And he continued to work on the artificial kidney.
The device was an exemplar of Rube Goldberg ingenuity. It consisted of 50 yards of sausage casing wrapped around a wooden drum set into a salt solution. The patient’s blood was drawn from a wrist artery and fed into the casings. The drum was rotated, removing impurities. To get the blood safely back into the patient, Dr. Kolff copied the design of a water-pump coupling used in Ford motor engines. Later he used orange juice cans and a clothes washing machine to build his apparatuses.
The first 15 people placed on the machine died. Dr. Kolff made refinements, including the optimum use of blood thinners to prevent coagulation. In 1945, a 67-year-old woman — who had fallen into a coma from kidney failure while in jail after the liberation — was put on the machine for a far longer period than earlier patients and lived. Her first words on coming out of the coma were “I’m going to divorce my husband.” She did (he was against the Nazis, and she was a collaborator) and lived seven more years.
In 1947, Dr. Kolff sent one of his artificial kidneys to Mount Sinai Hospital in New York City and began talking to American physicians also interested in artificial organs. Eventually the machine underwent improvements that enabled it to be used regularly by people whose kidneys had failed irreparably. Tens of thousands of people now undergo dialysis three times a week, often as a bridge to kidney transplantation.
In 1950, Dr. Kolff joined the Cleveland Clinic Foundation, where he first had to improve his English, retake his medical exams and undergo naturalization to become an American citizen, which he accomplished in six years. Shortly thereafter he developed a membrane oxygenator for bypass surgery and the first artificial heart that in 1957 kept a dog alive for 90 minutes.
He moved to the University of Utah in 1967 to lead the division of artificial organs, which is where his team of 175 physicians, surgeons, engineers, chemists and other specialists built a succession of mechanical hearts tested in animals.
In 1981, Dr. Kolff was granted permission by the university and federal officials to implant an artificial heart in a human. The recipient, Dr. Clark, received the heart on Dec. 2,, 1982. He lived for 112 days before dying of multiple organ failure.
Willem Johan Kolff was born in Leyden, the Netherlands, on Feb. 14, 1911. He received his M.D. at Leyden University in 1938 and a Ph.D. at the University of Groningen in 1946.
A founding member of the American Society of Artificial Internal Organs, Dr. Kolff obtained more than 12 honorary doctorate degrees at universities all over the world and more than 120 international awards, including the Albert Lasker Award for Clinical Medical Research, which he shared in 2002. He wrote numerous books and hundreds of papers and articles.
In 1937, Dr. Kolff married Janke C. Huidekoper. They divorced in 2000 after 63 years of marriage. Besides his son Therus, Dr. Kolff is survived by three other sons, Jacob, Albert and Kees, one daughter, Adrie Burnett, 12 grandchildren and six great-grandchildren. His former wife died in 2006.
Dr. Kolff continued to work on artificial organs, including eyes, ears and limbs, until he retired in 1997 at the age of 86. The artificial heart he developed is being used today, in subsequent designs, as a bridge to transplant in patients with heart failure.
“If a man can grow a heart,” Dr. Kolff always insisted, “he can build one.”
http://www.nytimes.com/2009/02/13/health/13kolff-web.html
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