Willem Kolff

Willem Johan Kolff (born February 14, 1911 in Leiden , South Holland , † February 11, 2009 in Newtown Square , Pennsylvania ) was a Dutch internist . He became known for the invention of an artificial kidney and his lifelong work on artificial organs. A woman he treated with acute kidney failure in 1945 is considered the first patient saved by dialysis.

Life

Replica of the drum kidney by Willem Kolff

Willem Kolff was born in Leiden, where his father was a doctor. When he took over the management of a sanatorium for tuberculosis sufferers, Willem moved to Beekbergen at the age of six .

Kolff studied medicine in Leiden from 1930 to 1937 . In 1937 he married Janke Huidekoper and the marriage had five children. From 1937 to 1940 Kolff was an assistant at the Medical Clinic of the University of Groningen . In 1941 he became head internist at the city hospital in Kampen , as he - according to his own statements - did not want to continue working under a National Socialist clinic director. The Netherlands had been occupied by the German Wehrmacht since May 1940. In 1946 Kolff received his doctorate in Groningen with a treatise on "De Kunstmatige Nier". In 1950 he emigrated to the USA. The reasons for this were difficulties in getting a desired academic position in the Netherlands, but also the "Red Danger" that he believed to be threatening and the skepticism about the country's future after the loss of its colonial empire.

From 1950 to 1967 Kolff worked in Cleveland at the Cleveland Clinical Foundation, from 1967 in Salt Lake City . He has received several professor titles and numerous honors. His marriage ended in divorce at an advanced age. Kolff died - still remarkably vital until his early 90s - at the age of 98.

Scientific achievement

Encouraged by the death of patients as a result of uremia, Kolff carried out laboratory dialysis with the biochemist Brinkman in Groningen from 1938 to 1940, for example with urea solution in a cellophane tube . The young assistant got to know this "artificial sausage skin", which is suitable as a dialysis membrane, from Brinkman, as well as a drum dialyzer. Kolff did not carry out animal experiments. The following were already known from the literature: Hemodialysis in animals by John Abel 1912/1913, by Heinrich Necheless in 1923 and Georg Haas 1915/1923/1924, hemodialysis in humans by Georg Haas from 1924 to 1928 and the use of heparin to inhibit blood clotting during dialysis by Haas and for animal dialysis with cellophane by Thalheimer.

During his time as head internist in Kampen, Kolff had the engineer and owner of an enamel factory, Hendrik Berk, build an "artificial kidney" according to his ideas in 1942. It was a drum made of aluminum (later wood), rotating horizontally in a rinsing solution bath and wrapped in cellophane tubing. When used on the patient, the patient's heparinized blood was passed through the tube with the semipermeable membrane. The membrane surface area was 2.4 m², only part of it was immersed in the rinsing solution and thus became effective. It was still a technically imperfect device for hemodialysis . A decisive disadvantage of Kolff's artificial kidney was that it did not allow excess tissue fluid to be withdrawn and thus pulmonary edema and hypertension could not be treated. This indispensable ultrafiltration was made possible by the dialysis machine developed by Nils Alwall in Lund from 1946.

Kolff used his device (he did not count one patient from February 1943) from March 1943 on 16 patients with acute and chronic kidney failure and poisoning . 15 of them died. Kolff published together with Berk on the "artificial kidney with large surface" in two Dutch magazines in 1943, and in 1944 he even succeeded in publications in Sweden (in English) and in France. Kolff had a very skeptical colleague at the hospital, the surgeon Kehr, who spoke of "kidney gimmick". After a demonstration treatment in front of colleagues and personalities of the city in July 1944, which ended in a "fiasco" due to the rupture of the blood-filled tube, Kolff initially did not perform any further dialysis, which was certainly also related to the war conditions in the German-occupied Netherlands.

At the beginning of September 1945, the 67-year-old patient Sophia Schafstadt was admitted to the hospital from a Dutch internment camp with acute kidney failure caused by a "neglected biliary tract infection". She was dialyzed with the drum kidney in Kolff's coma uraemicum for 11 hours and regained consciousness after this one-time treatment, which was not without complications. She could later be discharged with normal kidney function. Sophia Schafstadt is considered to be the first person rescued through dialysis treatment. Kolff kept the grateful woman in his department until Christmas: “I can't afford to let her die in the camp”. She was then released home and lived until 1952.

In 1946 Kolff defended his dissertation “De Kunstmatige Nier” in Groningen , in which he described the dialyses of the first 15 patients, as an appendix that of Sophia Schafstadt, as well as the technique of the drum kidney. Initially, he thanked the builder Hendrik Berk and his technical "kidney assistant" Noordwijk.

Kolff dialyzed eight other patients until 1947, two of whom survived. He couldn't convince in the Netherlands (and Europe) with his drum kidney. On the basis of a blueprint by Kolff and Berk, the device was thoroughly revised and further developed in the Peter Brigham Hospital in Boston , making it clinically applicable.

Kolff was now interested in the heart-lung machine and other artificial organs on which he worked after emigrating to the USA. But in 1956 - together with Bruno Watschinger from Linz - he developed the double-coil kidney "Twin Coil" as the first commercially available single-use dialyzer and used it in 1967 in Maytag washing machines and even in surplus NASA rocket tips as "artificial kidneys".

Appreciations

In 1947 he was awarded the Amory Prize of the American Academy of Arts and Sciences . In 1966 he received the Gairdner Foundation International Award , in 1982 the AMA Scientific Achievement Award and in 1986 the Japan Prize . On the list of De Grootste Nederlander in 2004 he was ranked 47th after a television vote. On November 15, 2005 he was voted “greatest Overijsseler of all time”. Kampen is in the province of Overijssel , where Kolff made his invention. He is an honorary citizen of Kampen. A memorial was placed in front of the Art Nouveau hospital in Kampen. In 2002 Kolff received the Albert Lasker Award for Clinical Medical Research , and he also received 13 honorary doctorates. A "Kolff Prize" has been awarded since 1998 and an annual international symposium on artificial organs has been held in his honor since 2003. There is a "Willem Kolff Stichting" (foundation).

On September 26, 2007 the asteroid (11427) Willemkolff was named after him.

literature

• WJ Kolff, H.Th.J. Berk: "De Kunstmatige Nier. A dialyzer met groot oppervlak". Geneeskunde Gids 21: No. 7 (1943), and in: Ned. Tijdschr. voor Geneeskunde 87, 1684–1688 (1943)
• WJ Kolff and H.Th.J. Berk: "The Artificial Kidney: a dialyser with great area". Acta Medica Scandinavica, Vol. 117, Fasc. 2 (1944)
• WJ Kolff: "De Kunstmatige Nier" (Proefschrift). Kampen, 1946
• WJ Kolff: "New ways of treating uremia". JA Churchill Ltd., London 1947
• WJ Kolff: "First Clinical Experience with the Artificial Kidney". Ann. Intern. Med. 62, 608-619 (1965)
• W. Drukker: "Haemodialysis: a Historical Review" in: "Replacement of Renal Function by Dialysis". Ed. by W. Drukker, FM Parsons and JF Maher. Martinus Nijhoff Publishers, Boston, The Hague, Dordrecht, Lancester. 2nd edition, 1983
• Herman Broers: "Dokter Kolff: artificial hair in hard kidneys". Mets and Schilt, Amsterdam 2003

Web links

• The first successful dialysis treatment
• History of dialysis
• Familievereniging Kolff Family Association
• Willem Kolff on the website of Yad Vashem (English)
• Entry about Willem Johan Kolff in the database of the Wilhelm Exner Medal Foundation .