History of artifical organs and transplantation

[okarol]

05/18/2008
History of artifical organs and transplantation

Robert J. White, M.D., Ph.D., is professor of neurosurgery at Case University School of Medicine. He is medical adviser on health issues to Medical Mutual of Ohio. He also writes a column for The News-Herald every other Sunday.
You may have heard or read about the renal dialysis machine which keeps people alive when their own kidneys have failed, and the mechanical heart which substitutes for a person's heart.

This relatively new field is the science of artificial organs which has already saved many lives, particularly the heart/lung machine that is capable of replacing both organs only for several hours during open heart surgery.

Yet, there's an important publication on this exciting research called "The Journal of Artificial Organs." This scientific journal is published in Painesville and may be the only such biomedical publication of such reputation produced in all of northern Ohio, with all of its great health institutions.

Editor Paul S. Malchesky is not a physician but has a doctorate in engineering.

Along with his associate, Angela Hadsell, and his devoted office staff and editorial board members, it represents some of the most important medical scientists and clinicians in the world.

But, Notheast Ohio has a rich history in this field.
In 1960, Dr. W.J. Kolff, the inventor of the kidney dialysis unit, arrived in Cleveland, where he worked for a number of years at the Cleveland Clinic Foundation on improving the kidney machine for renal dialysis. He also began working on developing a heart/lung instrument to be used for open heart surgery. He initiated his studies on the artificial heart that would eventually replace the human heart itself. Kolff left the Cleveland Clinic in 1967 and his brilliant assistant, Dr. Yukihiko Nose' continued Kolff's work on the artificial heart. The Cleveland Clinic pioneered the renal and heart machines that were perfected to assume the critical functions of both organs.

When I arrived in Cleveland in 1961, Kolff was already a scientist of international reputation when he took an interest in our work devoted to keeping the brain alive with an extracorporeal machine. I was delighted.

However, I was less than thrilled when he invited me to visit him at his laboratory to do neurological examinations on cattle who were surviving with just a mechanical cardiac device that he and his colleagues had designed and constructed in their workshop at the Cleveland Clinic Foundation. These animals were surviving days after their own hearts had been surgically removed and replaced with an early model of the artificial heart.

Kolff also sent me a cartoon, published in honor of my work on the human brain. It depicted a bald-headed old man sitting at the foot of his hospital bed looking at a chart which was constantly demonstrating a recording of his own brain waves.

Upon more careful inspection of the cartoon, it revealed that only the patient's brain, which was immersed in fluid, was placed in a large vat occupying the bed.

There were all wires and tubes attached to the brain to keep it alive and provide it with communication possibilities. Kolff sent a message with the cartoon that if I continued with my work on isolating the monkey brain and keeping it alive on machinery, when I died other scientists would keep my brain alive employing the same technology.

And if a patient's family members visited me they would receive answers to their questions or statements by reading my brain waves.

My personal contact with Dr. Kolff, and his inventions, began many years before he arrived in Cleveland.

When I was in general surgical training in Boston at the Harvard Peter Bent Brigham Hospital, I would often be required to go to the renal unit where I operated on the wrists of patients who were under dialysis and were required to be connected to the artificial kidney, which was as early as 1954. This surgical operation consisted of delicately exposing an artery and vein and inserting the tubes of the machine so the patient's blood could be circulated to and from the unit so it could be cleansed of impurities.

Today, both the human kidney and heart can be transplanted. Many lives are being saved at University Hospitals of Cleveland and the Cleveland Clinic Foundation through organ transplantation.

Despite its proud history, Northeast Ohio does not provide a sufficient number of donated organs for transplantation, nor does any other section in the country.

There is simply a tragic shortage of human organs and tissue for transplantation worldwide.

Some day, with the continued advancement in engineering artificial organs, this will become available to everyone.

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