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Memoriam and Tribute to Willem J. “Pim” Kolff, Founder of Artificial Organs

2009; Lippincott Williams & Wilkins; Volume: 55; Issue: 3 Linguagem: Inglês

10.1097/mat.0b013e3181a71c9f

1538-943X

Eli A. Friedman, Don B. Olsen,

Organ Donation and Transplantation

Preparing a memoriam and tribute for Willem J. “Pim Kolff” is a truly daunting task. His lifetime covered almost a century during which some of the most astounding advances in human existence occurred, not the least of which were Kolff's artificial kidney and artificial heart, and his work with Dobelle to create artificial vision. We begin with part of his opening speech as the founding President of American Society for Artificial Internal Organs (ASAIO) during the inaugural meeting at Atlantic City, NJ in 1954, which gives us the first glimpse of this truly remarkable person. The Artificial Kidney—Past, Present, and Future W. J. Kolff, MD (ASAIO Transactions, Volume 1, 1955) Members of this new society and guests: I wish to welcome you, and to make it perfectly clear that this meeting is taking place solely because Dr. Peter Salisbury conceived the idea and did all the work of preparing for it. If, at the end of this day the meeting is considered a success, Dr. Salisbury will be the one who will deserve all the credit for it. Not long ago, Eelco van Kleffens, President of the General Assembly of the United Nations, said: “My only aim in guiding our discussions has been to show my fellow delegates something of the Dutch concept of objectivity.” I cannot hope to do as well as the distinguished gentleman from my native country, but I shall try to uphold objective criteria in our discussions today. As an example of what happens when you lose objective criteria, let me read an excerpt of the first convention concerning the artificial kidney held in Rapallo, Italy, in 1954. “The most animated discussion was on whether the fractional or the continuous system of applying the artificial kidney should be used. With the fractional system, the artificial kidney stimulates the impaired kidney to recover, but it does not have a substituting action.” I need not tell you that we should harm the good name of our society should we allow similar fairy tales to go unchallenged. (Not included herein is a brief historical review.) In conclusion it may be asked: “Has the artificial kidney justified the expectations expressed in its name?” I believe that it has, and I cite five reasons for the belief: 1) the artificial kidney prolongs life for experimental animals and for humans devoid of renal function. 2) The artificial kidney reverses the clinical picture of severe, acute uremia within 24 hours and of chronic uremia within 2 or 3 days. 3) The artificial kidney displays this ameliorating effect also in the patients whose serum electrolytes are not changed by the dialysis. Thus, the artificial kidney substitutes for the excretory function of the kidney and, in reverse, it may be concluded that the clinical picture of uremia is because of the summation of the effects of dialyzable retention products whatever they are. 4) The artificial kidney can restore the electrolyte composition of the blood plasma even more rapidly than can the natural kidney. It even distinguishes between chloride and bromide—a distinction that the natural kidney is unable to make. 5) The artificial kidney does not substitute for some of the metabolic functions of the natural kidney, but none of those functions is of importance for the maintenance of life in the acute conditions for which the artificial kidney was originally designed. In conclusion, the artificial kidney is not subject to the many miserable diseases to which the natural kidney so easily succumbs. Following are Contributions from Colleagues and Others Touched by the Life of Willem J. ‘Pim' Kolff During Various Periods of his Professional and Personal Lives Excerpted from: Willem Johan “Pim” Kolff.Inventor, Visionary, and Bionicist (This is used to give a brief overview of Dr. Kolff's accomplishments in addition to the personal reflections). Eli A. Friedman, MD. Willlem Johan Pim Kolff, who died on February 11, 2009, at the age of 97, impacted and ultimately shaped every aspect of my adult life. Under the exceptional stress of the German occupation of the Netherlands during World War II, Kolff built and clinically tested, in 1943–1945, the first practical artificial kidney using parts from a destroyed German airplane and American sausage casing as his membrane. The first horizontal rotating drum artificial kidney used a sewing machine motor, attached to a bicycle chain that turned the drum, exposing circulating blood within cellophane tubing to dialysate in a 100 L porcelain tank with the tubing mounted on a drum built of wooden slats. While working on artificial kidney prototypes, Kolff significantly participated in the Dutch resistance and assisted in concealing Jews being selected for extinction. Although the first 15 patients treated with dialysis, as the treatment was named, died without evident benefit, the 16th, in 1945, awoke from coma and spoke validating Kolff's premise conceived in 1938 that advanced renal failure was a reversible syndrome. Published in 1946, Kolff's PhD thesis “The Artificial Kidney,” followed a year later by the first book anywhere devoted to dialysis “New Ways of Treatment Uremia,” transformed the medical management of kidney failure to include the option of dialysis treatments. In 1948, Kolff made his first visit to the United States, having sent a working model of his artificial kidney to a Dutch physician who immigrated to New York's Mount Sinai Hospital to escape German persecution. Attending a lecture by Kolff at Mount Sinai, in 1948, George W. Thorn, Hersey Professor of the Theory and Practice of Medicine at Harvard's Peter Bent Brigham (now Brigham and Women's) Hospital invited him to visit and subsequently assigned John P. Merrill (who was returning from Air Force duty), the task of adopting Kolff's device for easy production. Built at Fenwall Laboratory by associate engineer Edward Olsen, the redesigned Kolff Brigham Artificial Kidney was directly attached to the patient by surgical cannulae via a split coupling at the inlet and outlet of the rotating drum to prevent twisting of the cellulose membrane tubing. Membrane surface area and dialyzer clearance were adjustable by varying the number of wraps of tubing. A Plexiglas hood allowed control blood temperature. At a cost of $5,600 in 1948, the Kolff Brigham artificial kidney, become the standard artificial kidney sold to 40 institutions over the world from Tokyo to Chile. Merrill's basic studies of hemodialysis using the Kolff Brigham Kidney, reported in the Journal of Clinical Investigation, validated the scientific basis of dialytic therapy. In 1952, Dr. Paul Teschan showed that hemodialysis with the Kolff-Brigham device could be performed outside a hospital by his Korean War battlefield dialysis [in a Mobile Army Surgical Hospital (MASH)] to treat hyperkalemia complicating acute kidney failure. Reliance on the Kolff device resulted in successful performance of identical twin kidney transplants in 1954 by a freshly established Brigham Transplant Team. Several “kidney doctors” soon to be termed Nephrologists recognized the potential use of an artificial kidney to extract some poisons from the blood as documented by both George E. Schreiner at Georgetown University and Merrill (Figure 1).Figure 1.: After his gift of an artificial kidney to Mount Sinai Hospital in New York in 1947 and participation in redesign of his rotating drum artificial kidney as the Kolff Brigham Kidney in 1948, Kolff collaborated with American Nephrologists who began the specialty of Nephrology. Led by George E. Schreiner on the left and John P. Merrill on the right Kolff is seen at a President's reception held by the ISAO in 1979. (Photograph taken by Dr. Eli Friedman).Recruited in 1950 by Dr. Irvine Page to join the staff of the Cleveland Clinic Foundation, Kolff established a Department of Artificial Organs inventing cardiac substitution devices leading in 1957 to implantation of an artificial heart in a dog who survived for 90 minutes. By 1961, prototype intra-aortic balloon pumps were being tested by Kolff's team as a bridge during reversible acute myocardial distress. Still concerned with improving dialysis, Kolff and his research fellow, Dr. Bruno Watschinger, wound a tubular cellophane membrane around a large juice can using a Maytag washing machine as a tank for recirculated dialysate. Collaborating with Travenol Laboratories (later Baxter Travenol Co., Deerfield, IL), Kolff introduced the twin coil artificial kidney in 1956 at a cost of $1,400 with over 3,500 sold worldwide. Belding H. Scribner, at the University of Washington, conceived and fabricated an external plastic arteriovenous shunt for repetitive hemodialyses. In 1960, Scribner's team opened the path to repetitive use of an artificial kidney as a sustaining therapy for chronic uremia. For these remarkable medical advances, Kolff and Scribner were awarded the Lasker Prize in 2002 (Figure 2). To add vitality to the University of Utah's effort to design a total artificial heart (TAH), Kolff was appointed Professor of Research Surgery. In collaboration with veterinary surgeon, Dr. Donald Olson, and his student, Dr. Robert Jarvik, Kolff's team (after testing a new artificial heart in a calf), in 1982, had the device implanted by Dr. William DeVries in patient Barney Clark who survived for 112 days. Thus, Kolff championed the first successful bionic substitution of a second vital organ. No surprise, therefore, that Life Magazine, in September 2002, included Kolff in its listing of the 100 Most Important Americans of the 20th Century.Figure 2.: Depicted are the creators of uremia therapy that began with the ability to perform repetitive hemodialyses first using an external Teflon arteriovenous shunt conceived and fabricated by Belding H. Scribner (right). For this extraordinary advance in opening the era of vital organ replacement, Kolff and Scribner received the Lasker Prize in 2002. (Photograph taken by Dr. Eli Friedman).The over 150 prizes, plaques, and awards received by Dr. Kolff necessitated a designated building for their display in Utah while the city of Kampen erected a statue in Kolff's honor (Figure 3). He authored more than 600 articles, 10 books, and founded and was first President of the ASAIO and co-founded the International Society for Artificial Organs (ISAO). Summarizing his understanding of how artificial organs may impact life, Kolff advised the Dutch Organization of Kidney Patients in their magazine “Wisselwerking (Interaction)” that: “If you can give someone a happy life you should do it, if it cannot be a happy life you should not. When someone has an artificial heart and he has enough (of life) he should have a little key that he can turn it off. But, with a code, mind you, so his grandchildren cannot switch him off.”Figure 3.: In 2002, Kolff stands before Kampen City Hospital, in The Netherlands, alongside a statue honoring his accomplishments. Kampen Hospital will be renamed in Kolff's honor. (Photograph taken by Dr. Eli Friedman).Returning to how Kolff's existence directed my life, I note that my first rotation as an intern was on Merrill's artificial kidney service that dialyzed for poisonings, acute renal failure, and kidney transplants in identical twins. The romantic lure of Nephrology as a discipline induced me to accept a 2-year fellowship funded by the American Heart Association (no nephrology organizations had yet been formed). Subsequently, Barry, my wife, who developed diabetes during pregnancy, had progressive kidney failure culminating in a life or death need for dialysis that kept her alive for 4 months until she received her sister's kidney affording Barry 18 years of posttransplant life allowing interaction with grandchildren and fulfilling her wish to be a writer. Downstate Medical Center, where I spent my entire career, was selected to house the first federal dialysis unit and these pioneer patients formed the American Association of Kidney Patients for which I serve as Medical Advisor. After walking in Kolff's footsteps as President of ASAIO and ISAO, I spoke at his retirement ceremony at age 75 in Salt Lake City, finding that Kolff still wanted to be professionally active. Downstate was happy to confer both an Honorary Doctorate and an adjunct professorship. For the next 20 years, Kolff visited regularly, had photos taken with scores of faculty and fellows and communicated his contagious enthusiasm for a future conquering lung, heart, muscle, and eye diseases by bionic intervention. As this is written, our bulletin board hosts a smiling Kolff photograph which still turns heads with its inspirational message. No person I have ever met has done more to enhance life quality of our human race than, my friend and icon, Pim Kolff. Reflection of a day with Pim. Dr. Paul Teschan, Vanderbilt University Perhaps the most unique experience that Pim and I shared happened in October 1957, a 3-day closed meeting at the US Army Surgical Research Unit, Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX. Funded by our Surgeon General, and with a year's advance notice of the topics and session chairs this “Study Group on Acute Renal Failure” included virtually all of the published authors (13!) to that time on that topic. We shared our data on the morbidity and mortality of our patients and reached consensus on “best practices” and about unknowns needing research. I did allow them one afternoon “off” and took them on a tour of the Alamo. Excerpted fromInventor for Life The Story of W. J. Kolff, Father of Artificial Organs. Herman Broers, Biographer It is not only with the heart-lung machine that Kolff books success; after its introduction into US in 1949 his artificial kidney gains general acceptance. Contributing in particular to this is the team led by John P. Merrill in Boston. The team later also sends an artificial kidney to an American field hospital (MASH) during the Korean War. Between October 11 and November 4, 1952 a team led by Paul Teschan treats at least one wounded soldier per day on the artificial kidney; the lives are saved for 20 of them. Teschan reports to Merrill in Boston: “You will be interested to know that the kidney works as well in a rice paddy in Korea as in Washington.” The revolving drum of the kidney is even fitted with a crank in case of power cuts at the field hospital. Later, in the 1970s, Kolff's artificial kidney even features in an episode of the famous American TV series MASH, based on the comings and goings at a typical mobile field hospital in Korea. Excerpted from:My Life with Dr. Willem Kolf,Yukihiko Nosé (Artif Organs 22:969–979,1998) It was on June 9, 1960, that I was involved in surgery as an anesthesiologist for a TAH implantation in a dog with a large metal bellows blood pump which had been experimentally produced by Mr. Deijiro Oto of Nikkiso Company. This was the first successful TAH experiment in Japan, and we kept the dog alive for 4.5 h. Drs. Kazuhiko Atsumi, Motokazu Hori, and Takemochi Ishii were extremely happy with this achievement. At that time, I was designing a small micromotordriven roller pump for a blood pump in the engineering school. Dr. Ishii was also designing a small pneumatically actuating blood pump. One day, Dr. Motokazu Hori, a member of the surgical team at the University of Tokyo, brought a copy of the American Heart Journal and stated to all of us, “Sorry, 2 individuals named Drs. Willem Kolff and Ted Akutsu reported an artificial heart before we did.” At that time, the Cleveland Clinic Foundation, where Dr. Kolff had his laboratory, was one of the most active centers in the world in the field of artificial organs. Because I was interested in the artificial kidney, I fortunately had followed Dr. Kolff's work since 1943. Dr. Hori was the pioneer of the world's first artificial liver, and I was involved in both the fields of the artificial liver and artificial kidney. Dr. Kolff was devoted not only to an artificial kidney and heart, but also an artificial uterus and a membrane oxygenator. Unfortunately, at that time, the publication “Trans Am Soc Artif Intern Organs” was not available in Japan. I did not know it was the Transactions for the ASAIO. On April 14, 1962, the day I had presented a article on the artificial kidney utilizing the domestic electric washing machine and my professor Jiro Mikami one on the extracorporeal metabolic reactor as an artificial liver at the annual congress of the Japanese Surgical Society, I left Japan to study under Dr. Adrian Kantrowitz in Brooklyn, NY. In the process of purchasing my airline ticket, I had learned that for the same fare, I could stop over in Detroit and Cleveland before arriving in New York. Thus, I had decided to first visit Dow Corning in Midland, Michigan, and then visit Dr. Kolff at the Cleveland Clinic Foundation before arriving in New York. Unfortunately, the travel agent in Sapporo did not realize that my arrival in the United States would be on the same day of my departure because of the time difference between the United States and Japan. I had an appointment with Dr. Kolff, on the 17th of April, but I arrived 1 day early. Mr. Silas Braley of the Dow Corning Center for Aid to Medical Research was surprised by my arrival, and he informed Dr. Kolff and Dr. Kantrowitz. Unfortunately, Dr. Kolff was busy on the 16th of April; however, I was able to meet him at the front of the sixth floor elevator for a few minutes. I still remember what he said to me, “Oh, you are the Japanese working on the plastic anus. Dr. L. Turnbull, head of the Department of Colon Rectal Surgery, is anxious to talk to you. Sorry, I have appointments and am busy the entire day.” I was quite disappointed because, I had intended to show him an English narrated movie on hepatic assist and the artificial kidney. Luckily, Dr. Ted Akutsu was available, and he took me not only to the lab but also to a nearby bar and later to dinner. I was grateful for Dr. Akutsu's kind hospitality. At that time, I was really surprised to find out that the world renowned artificial organ laboratory of Dr. Kolff was a very small one. It was smaller than my artificial organ laboratory at the University of Hokkaido School of Medicine. However, many remarkable historical works had been generated in that small laboratory. Dr. Kolff's office was shared with his secretary. The office for four of his research fellows was in the hallway of the freight elevator. My impression of Dr. Kolff was that of a typical professor of medicine in Germany as described by Prof. Mikami of his experiences in Germany. He was very authoritative, stern, methodical, and straightforward, so I was scared to speak a single word to him. The next time I met Dr. Kolff was at an ASAIO meeting in April 1963 in Atlantic City, exactly 1 year later. He was the chairman of the session at which Drs. Akutsu, Atsumi, and I were three of the five panelists. Before the session, he called the three of us and said, “You Japanese cannot speak English well, so speak slowly. Do not show more than 10 slides.” Fortunately, Dr. Kantrowitz's lovely secretary and Mrs. Kantrowitz gave me more than enough tutoring for my paper presentation. Fortunately, Dr. Kolff understood my presentation on hepatic assist utilizing freeze-dried liver granules. At the ASAIO congress, I was scared to death to talk in front of him, the chairman. When a previous speaker had spoken for more than his designated time, Dr. Kolff had not said anything but instead had gone to the podium and forcefully retrieved the microphone from the speaker. I was wondering whether he would recognize me, not as the investigator on the artificial anus, but as the investigator on the hepatic assist. I was extremely grateful for his straightforward criticisms of my work on the hepatic assist. I was also the first author on another article on a serial type experimental left ventricular assist device, which was fortunately presented by Dr. Kantrowitz. In October 1963, I was quite fortunate to be able to implant the left ventricular assist device presented at the ASAIO congress in a dog. That dog survived for 14 days. At that time, nobody in the world, except Dr. Kolff and Dr. Akutsu, had been able to keep an experimental animal alive with a blood pump for longer than 24 h. Dr. Akutsu had kept two calves alive longer than 1 day with TAHS. Immediately after this event, Dr. Kantrowitz told me that I should visit Cleveland and present our results to Dr. Kolff. At that time, I was anxious to learn Dr. Kolff's philosophy on artificial organ research and development, so I had asked Dr. Kantrowitz to extend my stay in Cleveland for a couple of weeks. Dr. Kantrowitz gave me permission to stay there for 1 month. I will never forget that visit. On the way to Cleveland, the pilot announced something, and all the passengers started crying. I did not know what was going on. I asked what had happened. It was the announcement that President Kennedy had been assassinated. It was November 22, 1963. I stayed at the Cleveland Clinic for 1 month. Despite the excellent and warm hospitality extended by Dr. Kolff and his family, together with his two Japanese colleagues Drs. Ted Akutsu and Sat Nakamoto, the atmosphere of Dr. Kolff's laboratory was such that I was scared to death to be with Dr. Kolff. In the laboratory, Dr. Kolff demanded the meticulous, military-like, strict, and regimented scientific performance of everybody in the laboratory, behavior exactly matching his. This was almost 100% opposite the styles of Dr. Kantrowitz, Prof. Jiro Mikami in medical school, and Prof. Shigeru Watanabe in engineering school. However, I enjoyed and was extremely impressed with his morning conferences, held punctually at 8:00 each morning. Usually, these meetings lasted for 1 hour. Dr. Kolff had just initiated a chronic hemodialysis program headed by Dr. Nakamoto together with a membrane oxygenator and artificial uterus program headed by Dr. A. Sen Gupta, the TAH program headed by Dr. Akutsu, and several other exciting new programs. At the morning conferences, I presented not only the left ventricular assist pump program in Brooklyn but also the other artificial organ programs in which I was involved in Japan. One of the issues that very much disappointed me in terms of Dr. Kolff was his reaction when I presented my electric washing machine kidney and told him that the future of hemodialysis was at home. At that time, Dr. Kolff disagreed with me. However, within 1 year, he said, “I was wrong. The future is home dialysis.” This is typical of Dr. Kolff. He offers his straightforward opinion. He is not political. However, when he believes he is wrong, he corrects his previous opinion and accepts his mistakes. After I told Dr. Kolff that I would like to stay in his laboratory for 1 month, I realized I had made a mistake. For me, 1 month was too long to live in Dr. Kolff's strict environment. However, I learned a great deal from him during that month. At that time, I did not realize I would end up working for him in less than 6 months. Dr. Kolff left the Cleveland Clinic at the end of March 1967 to establish one of the most comprehensive artificial organ centers in the world at the University of Utah. His position at the Cleveland Clinic was divided into two, and they were inherited by Dr. Satoru Nakamoto for hemodialysis and me for research programs. It was the end of April 1967 that I officially took over Dr. Kolff's position. At that time, I sent all his equipment to him. All that remained were two small pencils in his desk drawer and the door plaque to his office, “W. J. Kolff, MD.” This sign still decorates my office wall in Houston as it did in Cleveland, serving as a momento of our great Dr. Kolff. It was in December 1976 that I met Dr. Kolff again in Washington, DC, at the Artificial Heart Contractor's Conference. I asked him to dinner, and he responded that he had to leave Washington that evening. I did not know his destination, but I later learned that he went to Cleveland. He visited my wife with flowers and said, “I am very proud of Yuki. It has only been 10 years ago that he inherited the Department of Artificial Organs from me. In Washington, DC, at the Artificial Heart Contractor's Conference, I was convinced Yuki had established the best program in artificial organs which surpassed my program in Utah.” Dr. Kolff had not said anything to me. As usual, he had criticized the way I conducted the artificial heart program in Cleveland, but he did complement my wife on my achievements. That was Dr. Kolff. I believe I was very fortunate to have had him as the teacher of my life. He is the godfather of my daughter Kimi Willhelmina. My first son Ken was also given his name, Willem, as his middle name. I was also grateful that he came to celebrate my 20th year anniversary as the head of the artificial organs program at the Cleveland Clinic. Dr. Kolff is not only my lifelong teacher, but also my father and the grandfather of my children. I wish Dr. Kolff and Janke Kolff the best of health so that they may continue to guide us in their unique style when we are not behaving properly. Excerpted from:Guest Editorial—To Honor Dr. Willem J. Kolff(Artif Organs 22:923–927,1998) Chisato Nojiri and Tetsuzo Akutsu, R&D Center, Terumo Corp., Kanagawa, Japan Dr. Tetsuzo Akutsu kindly gave me, Dr. Chisato Nojiri, an honorable opportunity to write an article commemorating Dr. Willem J. Kolff …. (The first part of the article is an interview of Dr. Akutsu by Dr. Nojiri.) Dr. Nojiri: What is the best memory of Dr. Kolff for you? Dr. Akutsu: There are many impressive memories of Dr. Kolff. Let me give some examples. When I did a major reconstruction of my house, he brought all the members of his laboratory to help with my last step of reconstruction. Everybody went up to the roof and replaced the entire roof with the new materials. When I went to his laboratory, I did not take my family with me for 4 years and 4 months. One good memory I have of that period is as follows. A few years after I joined his group, he bought 100 acres of land about 60 miles from downtown Cleveland. Almost every weekend, he kindly invited me to his farm, and I spent time with his family. What I did on his farm was cutting trees, cultivating the farm, strolling the forest, and sometimes I enjoyed fishing in the river that ran through his property. I really enjoyed it very much. He also invited me to his house in Cleveland for dinner very often. I was treated just like a member of his family. After I left his laboratory, every time I visited Salt Lake City, he kindly let me stay at his home. Early in the morning, he brought a cup of coffee to my bed. I was so surprised and almost jumped up (but, I did not). At that time, I was deeply impressed by his kind treatment. Every time I visited Salt Lake City, he came to the airport to meet with me and carried my suitcase. I was very much obliged. Dr. Nojiri: What did you learn from Dr. Kolff in your life? Dr. Akutsu: His personality itself. He is very sincere in everything, very strict in his work, and very warm. Dr. Nojiri: What did you feel when you left CCF, and what did Dr. Kolff say to you then? Dr. Akutsu: I felt very sorry to leave his laboratory, but I really wanted to have a chance to work on the ventricular assist device, which I could not do at the CCF. At that time I was planning on going back to Japan in 1 or 2 years; therefore, I wanted to be engaged in some other project than the TAH. Upon leaving, Dr. Kolff told me, “If you want, please go ahead,” and he had a big farewell party for me. Dr. Nojiri: Could you give him a word for his retirement? Dr. Akutsu: Please relax, stay healthy, enjoy your life, and live long. (Continuing—Dr. Nojiri) I first met Dr. Kolff in April 1986, when Dr. Hiro Fukumasu kindly invited me to a party for Dr. Kolff in Tokyo celebrating his Japan Prize because I was supposed to go to Salt Lake City the next year. In September 1987, I went to Salt Lake City to join Dr. S. W. Kim's group at the University of Utah. Although my main theme was the development of a small caliber vascular graft and nonthrombogenic materials research, Dr. Kim allowed me to work in the Artificial Heart Laboratory with Dr. Kolff and Dr. Olsen for several months before I went back to Japan because I am a cardiac surgeon. In July 1989, Dr. Kolff asked me to implant a small soft ventricle made by vacuum forming in a lamb as a left heart bypass. I performed surgery only once or twice for him; however, he was very pleased with my work. When my parents visited Salt Lake City, he kindly invited us to his home. Shortly after that, I went back to Japan carrying 20 cc soft ventricles with me. I have visited the US every year to attend the Annual Meeting of the ASAIO or for other purposes and have often stopped in Salt Lake City to see Dr. Kolff. When I first visited Salt Lake City after getting back to Japan, he picked me up at the airport and drove me to the hotel by himself. It was snowing outside, so I was expecting someone else to pick me up. I felt so apologetic about and deeply impressed by his kind treatment of me. After that, whenever I visited Salt Lake City, I wrote a letter in advance to say that I had rented a car at the airport. Another impressive story was that whenever I arrived at my hotel room in Salt Lake City, I found a fruit basket, some cheese, a bottle of red wine, and a wine opener, together with Dr. Kolff's hearty message. How nice it was! I congratulate Dr. Kolff for his great personality, through which he could achieve great success in his work and attract everybody who worked with him. Dr. Pim Kolff, we, Ted Akutsu, and Chico Nojiri, really miss you very much. Excerpted from: Kolff and Kantrowitz By Stephen R. Topaz I am a mechanical engineer, the first to spend his entire professional career in w