4 minute read
Willem Kolff
Willem Kolff: Machinery,
not Weaponry
Upper Sixth student, Viren Thandi wrote a short article for the Oxford science writing competition. Although he was not selected as a winner, his article is very interesting to read.
Willem Kolff lived in wartime Germany but did not experience bloodshed from the front line; instead, he came into contact with it through a machine. This machine would be developed in the future to save many lives - millions, in fact - yet during the early days of the invention, it received little praise The early dialysis machine must have seemed no more extraordinary than a whirring barrel in a laundry tub. Kolff’s discoveries are often overlooked by more ‘revolutionary’ developments in medicine, such as mass-producing the first antibiotic; for a nephrologist, however, to suggest that Kolff’s invention was not vitally important would be akin to dismissing the invention of the pacemaker in cardiology. Therefore, this begs the question: how did such a brilliant, impactful invention come to be?
Like many brilliant inventions, Kolff’s invention was the result of an observation made in 1938, and quite an unfortunate one at that. Whilst in his prime as a young student physician, studying at university, Dr. Kolff observed the suffering and ultimate death of a young man. The cause of death was temporary renal failure. This was undoubtedly a moment of great insight in Dr. Kolff’s life, as he was about to theorize an idea which would permanently change nephrology; by providing the build-up of waste products within the bloodstream following renal failure, he would be able to provide the patient with extra precious time in the absence of kidney functionality. This would allow the tissues within the kidney to regenerate sufficiently. Evidently, Dr. Kolff could not wait to perform post-doctoral research; he immediately began work on his designs for an
artificial kidney whilst still studying at the University of Groningen. Following his graduation from the University of Groningen in the Netherlands, Dr. Kolff began working within a small hospital in the same city where he had graduated. However, he was soon to encounter a difficult predicament; his hospital had had undergone a leadership change during German occupation of the Netherlands, a change which he naturally disagreed with, and he was forced to move from Groningen to a small hospital in Kampen. After moving to Kampen, in 1943, during the climax of the second World War, Willem Kolff developed the first functioning artificial kidney, but resources were limited; the first dialysis machine was constructed using a wooden barrel, a metal tub, an electric motor, a semi-permeable sausage casing - anything which Kolff had access to. The casing was filled with ions usually found in the
blood (magnesium and sodium ions) to prevent oxygen starvation, but no urea was present in the dialysate fluid. The dialysis fluid, in practice was brilliant - molecules of urea would diffuse into the dialysate fluid through multiple membranes, removing waste products from the blood, yet keeping useful ions within the bloodstream. The first artificial kidney undoubtedly had functionality, but not necessarily aesthetics! However, the first patients to use the artificial kidney encountered little success. The machine was only able to prolong their life by a couple of days in its early stages, meaning the machine failed to attract much acclaim in a time where money was better spent on rehabilitating soldiers and mass-producing medication. Despite this, improvements to the dialysis machine showed significant extensions to life post-1945. In 1945, a woman had an extra seven years of life with the aid of the artificial kidney; highlighting the dialysis machine as a suitable treatment of acute renal failure.
Over the length of his career, Dr Kolff attained a total of 12 honorary doctorates and 120 international awards. The dedication of an individual to his profession during a time of warfare where his research was limited by the resources available. Personally, I find Kolff’s contribution to the field of nephrology is extremely fascinating and is still very relevant in present day healthcare; globally, approximately 1 in 10 people have chronic kidney disease. If access to this vital life-saving piece of medical equipment improves, it has the potential to save millions of lives on a global scale.
Upper Sixth student, Ashley Kabue entered a short article titled ‘The Point of Pencils’ in the
