Inventor of kidney dialysis machine in wartime Holland and helped develop the artificial heart , Dr Willem Kolff dies aged 98

Willem Kolff (1911-2009) was born in Leiden, Holland the son of a doctor at a sanatorium and died yesterday in Philadelphia 2 days short of his 98th birthday.

He studied medicine and became an assistant physician in Groningen just before World War II. He resolved to find a solution for his often young patients who were put down for dead when their kidneys failed. Polak Daniëls his professor , committed suicide at the outbreak of the war. Kolff decided to leave Groningen because he refused to work with the successor, a National Socialist and established himself as a specialist in internal medicine in Kampen.

It was in Kampen working under German occupation and supervision where he developed the first artificial kidney during the war. With the assistance of a local enamel bowel manufacturer ( Henk Berk, director of the Kamper Emaille Fabrieken (Kampen Enamel Factories), and a local Ford garage owner who supplied a Ford fuel pump for the original design.

Whilst a pioner Kolff was not the first to demonstrate blood dialysis John Abel in 1914, ( Abel J, Rowntree L, Turner B (1914) J Pharmacol Exp Ther 5, 275-316 ) used anaesthetised rabbits and dogs and dialysis membranes made from treated parchment. After 2-3 hours of dialysis, the animals made complete recoveries. Whilst Abel's inention was to develop a way to measure the blood concentration of substances such as hormones, he highlighted the potential of his process as an 'artificial kidney'.

The (now universally accepted) principle of the method is that the kidney patient’s blood, which contains toxic waste products that are normally removed by healthy kidneys, is passed along a membrane through which small molecules (minerals and organic molecules such as urea) can pass. These pass through the membrane and end up in the rinse water flowing along the other side of the membrane. In this way the artificial kidney cleans the patient’s blood.

Kollf's system did not show any succes until the 17th patient was hooked up Wednesday March 17, 1943 ....after more than two years of experimention. “Thank god there was no ethics committee at the time,” Kolff said in an interview in 2003.

Further more it is clear that Kolff saved more people’s lives during the war by declaring them unfit for forced labour in Germany, or unfit for transport to camps. The first patient he saved with his early dialysis machine, Maria Sofia Schafstadt, was a collaborator during the war,and was a member of the NSB (Dutch National Socialist movement), closely linked to the Nazis.(see Kolff Institute website)

In 1950 Kolff, his wife and their five children emigrated to the United States in 1950 where he was able to raise the funds to develop his ideas which eventually included artificial kidneys, hearts and lungs. The first haemodialysis in the United States was undertaken under his supervision at Mount Sinai Hospital in 1947- today there are said to be 55,000 people in the U.S. with end-stage renal failure (ESRF) that are being kept alive by this invention, or subsequent developments of it. About 5,000 patients are diagnosed annually in the UK with chronic kidney failure resulting in the need for dialysis costing £25 - 35,000 per annum per patient.

In the socialized world of UK / NHS each kidney transplant costs approx £20,000, in 2002-3, 1775 people benefited from a kidney transplant. These transplants are calculated to be saving the NHS £37.6m in dialysis costs each year for every year that the kidney functions .

Dr. Belding Hibbard Scribner , a US physician invented the Scribner shunt, making long-term kidney dialysis possible. The dialysis machine, as originally developed by Dr. Kolff, used glass tubes that were inserted into veins and arteries which led to serious and progressive blood vessel damage. Kolff never patented his invention.

Dr Kolff was also involvd in the first implantation of the Jarvik - 7 artificial heart

In 1967 he became Professor of Surgery and Head of the Division of Artificial Organs at the School of Medicine at the University of Utah. His department helped to facilitate the first use of an implantable permanent mechanical heart. On Dec 1st 1982, in Salt Lake City an artificial heart designated Jarvik-7 after its creator, Dr. Robert Jarvik was implanted by William DeVries, MD to replace that of the dying 61 year old dentist Barney Clark , from Seattle, who survived 112 days but then died of pneumonia. (1982 - Prince William was born and the film ET launched)

The Jarvik - 7 is a device that is still used today and is claimed to have the highest success rate of any mechanical heart or assist device in the world. Since 1982, more than 350 patients have used the Jarvik 7 heart, and it remains in use today - called the CardioWest total artificial heart as Ownership has changed hands several times, but the device design remains essentially unchanged.



No Nobel Prize

Kolff received many medical awards. He was awarded the Japan Prize (1985), de Lasker Award (2002) the Russ Award (Feb 2003). In 1970 he was awarded Commandeur in de Orde van Oranje Nassau and entered the American Inventor's Hall of Fame in 1985.

He was passed over for the Nobel prize which many felt he deserved - word was he developed a process, did not cure a disease. Cynically it could be observed, kidney dialysis, especially in the young, makes long waiting lists for a kidney transplants possible and good sense.