Willem J. Kolff (b. 1911), a doctor working in occupied Holland during World War II, cobbled together the first kidney dialysis (hemodialysis) machine. When kidneys are not functioning correctly, waste products accumulate in the blood, and can be fatal. Kolff was aware of experiments showing that when two solutions of different chemical concentrations are separated by a permeable membrane an exchange of molecules takes place from the area of greater concentration to the area of lower concentration.
Kolff's machine consisted of 66 feet (20 m) of cellophane tubing wound around a wooden drum that was suspended horizontally inside a tank filled with saline. As the drum was rotated by a motor, the patient's blood was forced through the tubing and its waste products crossed the membrane into the saline. A severe shortage of materials due to the war forced Kolff to improvise; he used cellophane that came from sausage casings. Nevertheless, he was able to treat his first patient in 1943.
After the war Kolff moved to the United States, where he continued to improve the design of the artificial kidney, collaborating with a producer of intravenous and saline solutions. The first commercial artificial kidney was marketed in 1956. Initially dialysis was restricted to acute cases (drug intoxication, third- degree burns, and mismatched transfusions), with the idea of keeping people alive long enough for their kidneys to recover or the poison to be eliminated. By the early 1960s long-term dialysis was made possible by the development of a Teflon U-shaped shunt that was permanently attached to the patient.
