The kidneys serve a tremendously important role in the human organism, as 180 liters of blood plasma are cleaned and filtered every single day. Damage to the kidneys is common for a wide variety of reasons, and can be quite lethal. As with all organs, the availability of healthy donor organs for transplantation is very low compared to the number of people who need them. The insight of a astute researcher led to the development of the artificial kidney.
In 1939, while in Gronighen, The Netherlands, I took a piece of cellophane tubing (50 cm long), put blood in it with 400mg percent urea [metabolic waste in blood plasma], and shook it up and down in a bath with saline. To my surprise, within 5 minutes, nearly all of the urea was removed by dialysis because the surface area was large and both the blood and the dialyzing fluid were in continuous movement. To make an artificial kidney, I could simply multiply this 50-cm-length of cellophane tubing by twenty, and I would have enough cellophane to make clinical dialysis worthwhile. The cellophane tubing was artificial sausage skin.
After William Kolff's discovery (Kolff, 1998), the first clinically useful artificial kidney was made. It was made of a long cellophane tubing which was wrapped around a a steel drum which was spun in a saline bath. Blood was taken from the patient, circulated through the tubing, and then flowed back into the vein. Modifications on this design have been made over time, as there are now cheaper, smaller, more efficient, computer controlled machines. These artificial kidneys are used in hospitals and health care facilities all over the world to help inpatients and outpatients with failing kidneys They are also being used in novel contexts. Take, for instance, the "Dialysis at Sea*" cruise line.
We own an extensive inventory of dialysis equipment, all of which is maintained by our in house staff of factory trained technicians. We have dialysis machines available that are capable of doing standard, high efficiency and high flux treatments. These machines are transported to the ship, set up and calibrate on the departure day of the cruise by members of our staff. Representatives from our company see off every cruise. We meet with you on the day of sailing, introduce your medical staff and provide general orientation. Whenever possible, dialysis is done at sea to allow you as much free time aboard and in port as possible. You receive the same number of treatments as you would normally at home.
Unfortunately, the artificial kidney has not yet been made so as to make it a possible internal implant. The best devices we have for such an implant are not devices at all, they are actual kidney transplants. However, there have been some at least partially-successful attempts to make the artificial kidney machine small enough so that severe chronic dialysis patients can carry it around externally and lead active lives.
Artificial kidneys have certainly served individuals who need help filtering their blood due to kidney failure in order to live our their lives. For that reason alone, we should realize the great importance of such an invention. Kolff points out, though, that sometimes such inventions can have a bigger impact than just on one individual.
An artificial organ should not be used unless there is a reasonable hope that is will restore the recipient to a happy existence. There are a few exceptions to that rule. At times, an artificial organ has played an important role in history. Marshall Tito of Yugoslavia was kept alive with an artificial kidney until an orderly transfer of government took place. The government worked for several years until a combination of Croats and Serbs destroyed the old Yugoslavia.
General Francisco Franco was kept alive with an artificial kidney by one of my former associates, Dr. Cecilio Sanchez. The restoration of the King of Spain was the result, a system that is still working very well.
Yuri Andropov, the former head of the KGB who became President of the Soviet Union, was maintained with dialysis for 9 months. The appointment of Mikhail Gorbachev was the result.
(Quotes from Kolff, 1998)