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The Father of Dialysis. (Reviews).

The Nuts and Bolts of Life: Willem Kolff and the Invention of the Kidney Machine. Paul Heiney. Sutton Publishing. [pounds sterling]14.99. 232 pages. ISBN 0-7509-2894-8.

Anyone who has had a friend or loved one suffer from 'end stage renal failure' will have learnt much about dialysis. This is the procedure in which, over a four or five-hour period, a machine extracts a person's blood, purifies it and returns it. In effect, it is an artificial kidney and its work, done on average three times a week, keeps the patient alive and in tolerably good health. Without the treatment the patient would die. How this artificial kidney and other famous medical devices were invented is the story this book tells: it is in its way an adventure story with heroes and villains, failures and successes.

The hero is Willem Kolff, who, in the 1940s was a young Dutch physician working in a remote town in the Netherlands. Working on his own he invented and used the world's first successful artificial kidney. Kolff had seen a young man die of kidney failure and resolved to find a way in which to duplicate the work of healthy kidneys. Mr Heiney, who had access to a large collection of printed material as well as talks with Willem Kolff, tells the story in a manner that is as straightforward as the inventor himself. He describes how Dr Kolff used a God-given talent for invention to cobble together a machine which few today would recognise as a dialyser: one of the principal materials were sausage skins. He recounts the failures, the setbacks and the opposition faced by Kolff, the help of his wife and colleagues and the eventual success.

What makes the story a truly fascinating one is that Willem Kolff pursued his goal during the Second World War as German troops occupied his country. As Allied victory inched forward the Nazis made life for Kolff more and more difficult. How he got the help of those whose offer of help could have cost them their lives; how he scrounged round for any material that would work; how he was able to see that the simplest materials and procedures could do the most complicated things: all these carry the story forward and make it a real life adventure. Humour, even during war, and illness, are not missing; nor is irony: the first patient to be successfully dialysed and live was a Quisling who had become ill in gaol after the Liberation.

After the war, Kolff and his family emigrated to America in order to carry on his researches. Life there was not quite the Promised Land that readers might suppose and the Dutchman seemed to face as many problems as in Holland. Eventually he found an agreeable home in the University of Utah where his inventive genius could work unhindered. In many ways one of the most fascinating parts of this fascinating book is the story of how in different situations and with different problems, Kolff 'saw through' a problem and came up with a solution. These solutions included, in addition to the artificial kidney, Europe's first blood bank, oxygenators and an artificial heart. His idea for a devise to add oxygen to blood (an oxygenator) came from simply observing the colour of blood after it had been dialysed. Obvious when one thinks of it but who before Kolff had thought of it?

The author is successful in explaining the complicated medical procedures and the biological details so that laymen can follow what is going on. Occasionally one would have liked more biographical details about Willem Kolff, about the break with Robert Jarvik, about Kolff's liberal political views and about the collapse of Kolff's marriage after so many years. Sometimes personal facts seem to seep out of the narrative. The fact that the book was written about a subject who is alive must have placed some limitations on the writer. Where the author excels is in showing an inventive genius at work, a man whose aim has been to help others by bridging the gap between practical research and medical knowledge. We not only see Kolff's successes and failures but the limits of his understanding at particular times: his hope in 1945 was that his kidney machine could help damaged kidneys to recover. He did not foresee dialysis as a way to keep patients alive because the necessary 'shunt' was not yet available. Throughout Kolff's aim has not been to make money but to serve mankind, or at least that portion which has been struck by serious illness. This is a story that needed to be told and we are grateful to Paul Heiney for having told it.
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Title Annotation:The Nuts and Bolts of Life: Willem Kolff and the Invention of the Kidney Machine
Author:Bradbury, Edward
Publication:Contemporary Review
Article Type:Book Review
Date:Mar 1, 2003
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