Remembering Willem Kolff

Willem Johan "Pim" Kolff died February 11, 2009 – or 3 years ago today. He invented the dialysis machine. And, more generally, he was a pioneer in the development of artificial organs. 

At the time of his death many obituaries were published -- I will excerpt several of them. Here is one that describes his early life: 

“Dr. Kolff was born in the Netherlands on February 14, 1911. His father, Jacob Kolff, was a medical doctor and the director of a tuberculosis sanatorium in the town of Beekbergen, the Netherlands. Following in his father's footsteps Willem decided on a medical career. He studied medicine at the University of Leiden and graduated with his medical degree in 1938.

Following his graduation he did postgraduate work at the University of Groningen, from which he received the Ph.D. cum laude, in medicine in 1946. Between his graduation from the University of Leiden with the medical degree and the awarding of his Ph.D. from the University of Groningen was the Second World War. He apparently managed to stay clear of much of the disruption caused by the war by practicing medicine in the town of Kampen in the province of Overyssel in the Eastern part of the Netherlands.

"I wanted to make an artificial kidney that would save people. I was convinced that I could do it, and I clung to it until it was done."

During his time in Kampen, Kolff became motivated to develop the artificial kidney because of a 22 year old man who was dying from renal failure. 

The New York Times obituary relates the story:

“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.

Fig. 1: Museum Boerhaave Kolff's Artificial Kidney

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.”

The NY Times obituary continues: “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 (Fig. 1). 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 Manhattan and began talking to American physicians also interested in artificial organs.”

Fig. 2: Patient receiving dialysis via the Kolff-Brigham kidney

On June 11, 1948, the Kolff-Brigham kidney was used at Peter Bent Brigham Hospital in Boston, MA, and was believed to be the first application of an hemodialysis machine constructed in the US (Fig. 2). At the Cleveland Clinic, he was involved in the development of heart-lung machines to oxygenate blood and maintain heart and pulmonary function during cardiac surgery. He also improved his dialysis machine.

In 1967, Kolff became head of the University of Utah’s Division of Artificial Organs and Institute for Biomedical Engineering. It was in Utah where the first artificial heart for human use was developed using Dr. Kolff's principles. The developer was Dr. Jarvik, and the first artificial heart recipient was the California dentist Barney Clark. In 1982 the first heart transplant surgery was performed by another Dutch American, Dr. William C. DeVries. The heart received by Mr. Clark was named the Jarvik-7 artificial heart device.

Kolff also carried out research which showed that the electrical stimulation of certain parts of the brains of blind people could produce the sensation of seeing points of light. His research bore fruit when in 1999 his collaborator William Dobelle fitted a Brooklyn man with the world’s first artificial eye. 

Kolff retired officially in 1986, but he continued to work as a research professor and director of the Kolff Laboratory at the University of Utah until 1997. 

Dr. Kolff married Janke Huidekoper in 1938. There is no information available on whether the couple had children. Dr. Kolff passed away in 2009 close to his 98th birthday. He had lived a long and productive life.

Here is a link that has an interview with Dr. Kolff. Sources for the above article are in the links 1, 2, 3,4,5