Willem J. Kolff, at 97; Dutch inventor of artificial heart and organs

J. Willard Marriott Library, University of UtahIn 1947, the modern-day CardioWest artificial heart began as a dream of Dr. Willem Kolff, inventor of artificial organs. J. Willard Marriott Library, University of UtahIn 1947, the modern-day CardioWest artificial heart began as a dream of Dr. Willem Kolff, inventor of artificial organs. (J. Willard Marriott Library, University of Utah)
By Sandra Blakeslee
New York Times / February 16, 2009
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NEW YORK - Dr. Willem J. Kolff, a resourceful Dutch physician who invented the first artificial kidney in a rural hospital during World War II, using sausage casings and orange juice cans, and went on to build the first artificial heart, died Wednesday at his home in Newtown Square, Pa. Dr. Kolff, whose work has been credited with saving millions of lives, 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 said.

Dr. Kolff, who immigrated to the United States in 1950, was widely regarded as the father of artificial organs, having proved that biomedical engineers could build many kinds of artificial organs for keeping patients alive. His artificial kidney evolved into modern dialysis machines for cleansing the blood of people whose kidneys have failed, preserving countless 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 - is still in use in subsequent designs, as a bridge to transplantation in patients with heart failure.

The artificial heart was first implanted into a person, a 61-year-old retired dentist named Dr. Barney Clark, in 1982. It carried Jarvik's name because it was Dr. Kolff's policy to attach the name of the co-worker who was currently working on any particular model of artificial heart, according to Dr. Kolff's biographer, Herman Broers, in the book "Inventor for Life."

When it came time to implant a heart into a patient, Broers said, the Jarvik-7 was chosen because it had a multilayer diaphragm, designed by 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 it 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 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. 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 1937, Dr. Kolff married Janke C. Huidekoper. They divorced in 2000 after 63 years of marriage. Besides his son Therus, Dr. Kolff leaves three other sons, Jacob, Albert, and Kees; a daughter, Adrie Burnett; 12 grandchildren; and six great-grandchildren. His former wife died in 2006.

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