Willem Kolff (1911-2009) missed out only on the Nobel prize

Willem Kolff developed the artificial kidney during World War II. He passed away on Wednesday at the age of 97.

Willem Kolff never received the Nobel prize. The elderly inventor of the artificial kidney died in his home in Newton Square, near Philadelphia, this week. The past years he was high on the list of Nobel hopefuls in the Netherlands. The last two years it was said, ‘if it doesn’t happen this year, it’s not going to happen.’ It never did happen.

It will probably always remain a mystery why Kolff missed out on the prize. The rumour sometimes circulated that it was because he had only developed a technique. But other people have won the Nobel prize for medicine for developing a technique.

Kolff developed the forerunner for kidney dialysis, which has since enabled millions of kidney patients to live about ten years longer. These days many dialysis patients can add years to their lives when they finally receive a donor kidney, if they are young and healthy enough. To look at it cynically, kidney dialysis also makes the long waiting lists for a kidney transplant possible.

Basis of dialysis

Kolff lived to the age of 97. On Saturday (14 February) he would have turned 98. Willem Kolff was born in Leiden the son of a doctor at a sanatorium. He studied medicine and became an assistant physician in Groningen just before World War II. There he decided to find a solution for his often young patients who were put down for dead when their kidneys failed. His professor in Groningen, Polak Daniëls, committed suicide at the outbreak of the war. Kolff decided to leave Groningen and established himself as a specialist in internal medicine in Kampen.

There he developed the first artificial kidney during the war. With the assistance of a local enamel manufacturer and a garage owner. The principle of the method is that the kidney patient’s blood, which contains toxic waste products that are normally removed by healthy kidneys, is passed along a membrane through which small molecules (minerals and organic molecules such as urea) can pass. These pass through the membrane and end up in the rinse water flowing along the other side of the membrane. In this way the artificial kidney cleans the patient’s blood. This principle is still the basis of kidney dialysis.

Medical awards

The artificial kidney did not prove successful until the seventeenth patient was hooked up, after more than two years of experimenting with patients. “Thank god there was no ethics committee at the time,” Kolff said in an interview in 2003. It is clear that as a doctor Kolff saved more people’s lives during the war by declaring them unfit for forced labour in Germany, or unfit for transport to camps. The first patient he saved with his early dialysis machine, Maria Sofia Schafstadt, was a collaborator during the war, according to his biography on the Kolff foundation’s website.

In 1950 Kolff, his wife and their five children emigrated to the United States. He could not raise enough money in the Netherlands to further develop the artificial kidney, heart-lung machine and artificial heart. He developed these devices in the US however. In 1967 he became professor at the University of Utah. In 1990 Time magazine put him on its list of the hundred most important people of the twentieth century. He received all the medical awards that could be won in his field. But that most prestigious award never came.