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The theme chosen for the 2002 annual Bamberg Nephrology Seminar, held on 21-22 June, was the History of Nephrology. Professor Schultz, organising the programme, had invited many eminent names from the history of dialysis to make presentations. Not surprisingly, at the top of the list was Dr Willem Kolff, whose pioneering work laid the foundations for the modern treatment of kidney disease.

However travel is not so easy for Dr Kolff now that he is in his nineties and suffers from failing eyesight, so he was grateful to Kadija Raoudi of Membrana for assisting with his travel arrangements and generally smoothing his path.

In a 30 minute talk entitled 'Personal experience with Artificial Organs ' Dr Kolff took the audience back to the early days of the first artificial kidney, using 130 feet cellophane tubing made from sausage skins wrapped round a rotating drum made of aluminium strips.

As Dr Kolff related to a fascinated audience, this machine also led directly to the development of the first membrane oxygenator, through the observation that blue blood became red while in the cellophane tube. Other innovations followed swiftly - including the wearable artificial kidney, a simple two-compartment sterilisation process for simple and inexpensive peritoneal dialysis in countries where funds are scarce, and SPAD - the subcutaneous peritoneal access device, which can revolutionise life for insulin-dependent diabetic patients.

Not surprisingly Dr Kolff was also deeply involved in organ transplantation programmes as they became possible in the 1960s. He told a wonderful cautionary tale, however.

'One day at the Cleveland Clinic, a Mr Taylor was declared dead after long and many attempts to resuscitate him had failed. My son, Jack Kolff, knowing how eager we were for cadaver kidneys, put over the bed a cardiac massage machine that was constructed from an electric lawn mower. It rhythmically compressed the chest. The widow could not be found, and Jack continued the cardiac compression machine.

At 11 o'clock that night, the anaesthesiologist came in just to show an interest, and said: "My God, his pupils react." He questioned - "Mr Taylor, how do you feel?" and the patient answered, "Fine." Half an hour later, the would-be widow called: "Dr Kolff, did you try to reach me?" "Yes, Mrs Taylor. We had some trouble but he is doing all right."

Mr Taylor developed no renal trouble, and I shook hands with him four weeks later when he went home.' The moral, said Dr Kolff, is not to give up on kidneys…

Dr Kolff's research into artificial hearts, including the air driven 'Jarvik' heart implanted in Barney Clark, is familiar to many but perhaps less well recognised is the importance of the state of health of recipients of heart transplants. Dr Kolff presented the stark reality that if recipients are in poor health, one patient in four is likely to die - whereas if patients are first restored to health using an artificial heart or a left ventricular assist device, the success rate of the transplantation soars to over ninety-five per cent.

Dr Kolff concluded his talk with the latest news on his current project, age and poor sight being no bars to innovation as far as he is concerned. The wearable artificial lung, designed to help people in the painful and distressing final stages of pulmonary disease, is now well advanced, and Dr Kolff is in discussion with a number of companies to provide the components he needs. And that's where Membrana comes into the picture again - by developing a small experimental oxygenator for the project.
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