Portal de Periódicos da CAPES

Willem Johan Kolff

2009; Elsevier BV; Volume: 373; Issue: 9670 Linguagem: Inglês

10.1016/s0140-6736(09)60673-5

1474-547X

Geoff Watts,

Anesthesia and Neurotoxicity Research

Pioneering inventor of artificial organs. Born on Feb 14, 1911, in Leiden, the Netherlands, he died on Feb 11, 2009, in Newton Square, PA, USA, aged 97 years. “Whenever I see a problem”, Willem Kolff once said, “I try to reduce it to simple terms. If the problem is very complicated I look at whether or not there is a simple component to it. And if the simple component is an important part, I take that first.” For Kolff himself this formula clearly paid off. In a long and productive working life he set up the first blood bank in Europe, devised a cluster of medical inventions including an intra-aortic balloon pump for patients in acute cardiac failure, and, most notably, the first artificial kidneys and implantable hearts. The inventing began in the Netherlands where Kolff was born to a father who ran a tuberculosis clinic. Having graduated in 1938 from the medical school at University of Leiden, Kolff took a job in Groningen University. Motivated in part by having witnessed the death of a patient through renal failure he was seized by the idea of turning dialysis—already a concept familiar to doctors—into a practicable method of replacing the functions of a diseased kidney. Using various bits of available equipment, including barrels, laundry tubs, and, above all, cellophane tubing of the kind used to encase sausages, he cobbled together an artificial kidney. The first 15 of his patients survived only a few days, but the 16th lived. Kidney dialysis worked. In the Netherlands, by this time emerging from the years of war and German occupation, times were hard. In the small town hospital in Kampen—to which Kolff had moved to avoid working under a Nazi-appointed head of department—opportunities for medical invention were limited. But in 1950 he took a job in the USA at the Cleveland Clinic in Ohio. Here, with dialysis now established and undergoing rapid development and improvement, he set himself a new goal: to invent a heart-lung machine. The pump-oxygenator he built was effective and helped to make open heart surgery a feasible technique. But Kolff had become increasing absorbed in another and even greater challenge: to create an implantable artificial heart. After moving to the University of Utah, in 1967, Kolff began making important progress on this new ambition. As director of its Institute of Biomedical Engineering he assembled a team of surgeons, physicists, and cardiologists. Among them was Joe Andrade who went on to become the University's professor of bioengineering. Kolff always had the capacity to empower others, says Andrade: “People from around the planet were attracted to work with him. He sometimes saw more in people than they could see in themselves. He could invigorate them to do interesting things. Many of these people went on to found their own groups and technologies.” Another ex-colleague, a veterinarian by training, is professor Don Olsen who joined Kolff at Utah in 1972. Although he describes his sometime employer as “a demanding, and stern boss and teacher”, he adds that Kolff was able to see further down the road than most of us. “He would keep challenging people to do something better.” Kolff and his team developed a series of artificial hearts, each named after the member of the group responsible for that particular device. The model that eventually proved itself in patients was perfected by one of the young doctors in the team, Robert Jarvik. In an operation done in December, 1982, the first recipient of the new heart was a retired dentist called Barney Clark. He lived for almost 4 months. Although everyone within the field of artificial organs knows the full extent of Kolff's contributions, some think he didn't always receive the public recognition due to him. “He was generous at sharing the credit with his co-workers and that became most pronounced at Utah with the first artificial heart implantation”, says Andrade. Kolff encouraged his staff to put their own names to the devices they were working on. “He did this to motivate people”, says Olsen. So at the time of the first implant, the media concentrated on Jarvik. Andrade recalls how “He [Jarvik] happened to be young, and somewhat charismatic, and he kind of became the poster-child for the event”. Andrade confirms the oft repeated suggestion that Kolff was disappointed about one thing: not to have received a Nobel Prize. That said, he won pretty well everything else including, in 2002, a Lasker Award. He is survived by four sons and a daughter.