Willem Kolff dies

Willem Kolff with artificial heart
courtesy of the Willem J. Kolff Collection
at the University of Utah Marriott Library

Willem Kolff, a University of Utah physician who invented the precursor to kidney dialysis and the first artificial heart, died last week a few days shy of his 98th birthday. Kolff received the 2002 Albert Lasker Award for Clinical Medical Research. He died of natural causes, the New York Times reported. The artificial heart that he helped develop "has now been used in over 780 people," Don Olsen, a veterinarian at the University of Utah in Salt Lake City, who worked with Kolff on the artificial heart, told The Scientist. In addition, he pioneered some of the early work on heart lung machines and cardiac-assist devices, said Joe Andrade, a bioengineer at the University of Utah who helped design some of the materials in the artificial kidneys and heart. His lab was "in the forefront of almost all modern developments and innovations in surgery," Andrade said. Kolff has published more than 425 papers, which have collectively been cited more than 5500 times. Kolff was born in the Netherlands February 14, 1911. His father was a doctor who ran a sanitarium for tuberculosis patients. From a young age, he was deeply affected by the suffering of his father's patients, but wanted to become a zookeeper rather than a doctor. "When I was very young, I didn't want to become a doctor because I didn't want to see people die," he told The Academy of Achievement in a 1991 interview. "Later in my life, the main purpose of most of the machines I have made is to prevent people from dying." He eventually abandoned his dreams of zookeeping and attended the University of Leiden Medical School, in the Netherlands, according to The Telegraph. When Germany occupied the Netherlands in 1940, he moved to a remote village called Kampen, rather than collaborate with the Nazis who took over his hospital in Groningen. While there, Kolff watched a young man die from kidney failure as toxins slowly poisoned his blood. Kolff realized that if waste like urea were removed from the man's blood, he might have survived. Kolff set to work designing a crude device made of sausage casings, and circulated a mixture of blood and urea through it. On the outside of the tubing was a saline solution. After shaking the setup, he found the urea and other toxins were small enough to pass through the casings, while the purified blood stayed inside them. By filtering a patient's blood through the system, Kolff could take on the role of their kidneys while they recovered. The first 15 patients receiving his treatment died. The 16th patient was a Nazi collaborator who was despised in the Netherlands, "and darned if he didn't save her with the artificial kidney," said Olsen.

Willem Kolff with a woman who received an artificial kidney and a calf with an artificial heart
Courtesy of the Willem J. Kolff Collection at the University of Utah Marriott Library

After the war, Kolff moved to the Cleveland Clinic in Ohio, and in 1967 he became the head of the Division of Artificial Organs and the director of the Institute for Biomedical Engineering at the University of Utah. His experiences in the war had made him a "very hard, tough man" who always let the people under him know where they stood, Olsen said. "He was very personable and quite sensitive. But on the other hand he was a very hard boss. I was not able to always keep up and execute his marching orders," Olsen said. At the University of Utah, he tinkered with artificial eye, ear, pancreas, and lung projects, Olsen said. His most notable achievement was the artificial heart, however. Kolff tried many versions, including solenoid and pendulum-powered hearts, he said. The version that ultimately worked was made of polyurethane and relied on compressed air. Air was pulsed under a diaphragm, and as the diaphragm rose, it pushed blood through an outflow valve. When the air was released, the diaphragm collapsed and allowed blood to flow back into the heart, Olsen said. The first version was implanted into Barney Clark in 1984. He lived four months after the transplant, and the heart was still functioning when he died, Olsen said. Kolff retired from the university in 1986 but continued to work on projects and head a research laboratory until 1997, the Telegraph reported. And even at the Philadelphia assisted living facility where he died, he continued to work, said Andrade. "They had a craft room for these older folks, and he kind of took it over, and not only made a partial lab out of it, but also recruited these folks to help him with some of these ideas," he said. Throughout his life, he continued to work closely with his patients, often checking in on them when they were undergoing dialysis, Olsen said. "His kidney patients just loved him," Andrade said. He also developed a wearable kidney so that dialysis patients could experience the desert scenery that he enjoyed so much. He took patients with the wearable kidney on rafting trips along the Colorado River. "This didn't get into market because the physicians felt that it was too risky, but Dr. Kolff did it for several years," Olsen said.