07/11/2025
*Анхны диализийн машин*
# # # 1943 он. Кампен, Нидерланд.
Нидерланд гурван жил нацистуудад эзлэгдээд байв. Хүнс хомсдож, эм тариа олдоц муутай, эмнэлгүүд боломжоосоо давсан нөхцөлд ажиллаж байлаа. Еврей эмч нарыг ажлаас нь халж, заримыг нь хүчээр явуулжээ. Эмнэлгийн нөөц, хэрэгслийг Германы цэргүүд хурааж байв.
Энэ хүнд хэцүү нөхцөлд, Кампен хэмээх жижигхэн хотын нэгэн эмнэлэгт эмч Виллем Колфф зуу зуун жил эмч нарыг тарчлаасан асуудалтай нүүр туллаа: бөөрний дутагдал бол үхэлтэй адил байсан.
Хэрвээ хүний бөөр ажиллахаа больвол—өвчин, гэмтэл, халдвар зэргээс шалтгаалан—биеэс хоргүй бодисууд гадагшилж чадахгүй, цусанд хуримтлагдана. Эмч нар юу ч хийж чадалгүй, өвчтөнөө сульдаж, комд орж, эцэст нь нас барахыг хардаг байв. Хэдхэн хоног, эсвэл долоо хоногийн дотор л амь нь тасардаг байжээ.
Колфф ийм үхлийг олон удаа харсан. Залуу хүмүүс. Эцэг эхчүүд. Хэрвээ бөөрийг нь цэвэрлэж чаддаг байсан бол олон жил амьдрах байсан хүмүүс.
Тэр нэгэн санаанд оромгүй, шинжлэх ухааны онол дээр суурилсан, гэхдээ тухайн үед хийж боломгүй мэт сэтгэлгээтэй санааг бодож олжээ.
**Хэрвээ биеэс гадна цусыг цэвэрлэж чадвал яах вэ?**
Онолын хувьд боломжтой. Цусыг хүний биеэс гаргаж, шүүх ямар нэгэн системээр дамжуулах. Уураг болон цусны эсүүдийг хадгалаад, жижиг молекулууд (шээсэнд байдаг бодисууд) нэвтэрч чадах мембранаар шүүгээд, цэвэрлэгдсэн цусыг буцаан биед нь хийх санаа байв.
Гэхдээ 1943 онд, нацистуудын эзлэн түрэмгийлсэн Нидерландад, ийм төхөөрөмж бүтээх боломж үнэндээ байгаагүй. Гэсэн ч Колфф зогссонгүй.
Тэр хэрэгтэй материалуудыг эмнэлгийн бус, ахуйн хэрэглээнээс олж авч эхэлжээ.
🔹 **Целлофан хоолой** — Хиамны бүрхүүл хийхэд ашигладаг. Энэ нь хагас нэвтрэх чадвартай: жижиг молекулууд нэвтэрч чаддаг ч том молекулууд нэвтэрч чаддаггүй. Иймээс энэ нь хиймэл бөөрний мембран байж болох байв.
🔹 **Угаалгын машины хүрд** — Цус агуулсан целлофан хоолойг хүрдэнд ороож, цэвэр шингэнтэй саванд эргүүлэн дүрж байвал, эргэлтийн явцад цус шингэнтэй холбоо тогтоож, бохир бодисууд нэвтэрч чадна.
🔹 **Сэлбэг, төмрийн хаягдал** — Хуучин насос, металл карказ, янз бүрийн хоолой, эмнэлгийн төхөөрөмжийн сэлбэг.
Эцэст нь, 1943 онд, тэр нэгэн эмнэлгийн цехэд Колфф анхны ажиллахуйц хиймэл бөөрний аппаратыг бүтээжээ.
Энэ нь ердийн нэг угаалгын төхөөрөмж шиг харагдаж байв: модон карказ дээр целлофан хоолой ороосон хүрд, метан саванд хийсэн шингэн. Насос нь цусыг дамжуулж байв. Тухайн үед хэн ч үүнийг эмнэлгийн төхөөрөмж гэж бодохооргүй байв.
Эхний туршилтууд бүтэлгүйтсэн. Механик талаасаа ажиллаж байсан ч, өвчтөнүүд амьд үлдэж чадаагүй. Цус бүлэгнэх, халдвар, техникийн доголдлууд гарч байв.
Колфф шантраагүй. Тэр төхөөрөмжөө улам сайжруулж, шингэний найрлагыг өөрчилж, хэрэглээг нарийвчилж, дахин дахин туршсан. Өвчтөн бүрээс сурч, шинэ шинэ өөрчлөлт хийж байв.
1945 оны 9-р сард, Дэлхийн 2-р дайн дөнгөж дууссан үед, 67 настай Софиа Шаффстад гэх эмэгтэй бөөрний хурц дутагдалтай, уремийн комд орсон байдалтай эмнэлэгт иржээ. Цус нь хорт бодисоор дүүрч, амьдрах хэдхэн цаг үлдсэн байв.
Колфф эмэгтэйг машиндаа холбоод 11 цагийн турш цусыг нь аппаратаар шүүн цэвэрлэжээ. Хорууд мембранаар нэвтэрч, шингэн рүү гарсан байна.
Эмчилгээний дараа Софиа ухаан оржээ. Бөөрний үйл ажиллагаа нь сэргэж эхэлсэн. Тэр амьд үлдсэн.
**Түүхэнд анхны амжилттай диализ эмчилгээ ингэж бүртгэгдсэн юм.**
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1950 онд тэр АНУ руу нүүж, Кливлендийн клиникт ажиллажээ. Тэндээ аппаратаа сайжруулж, бусад эмч нарт сургалт хийж, олон нийтэд зориулсан үйлдвэржилтийг дэмжижээ.
1960-аад он гэхэд диализийн машин нь хэдэн мянган хүнийг аварч байсан бол, 1970-аад он гэхэд хэдэн арван мянган хүний амийг хамгаалж байв. Өнөөдөр сая сая хүн диализ хийлгэж, олон жил амьдрах боломжтой болсон.
Орчин үеийн диализийн машинууд компьютерээр удирддаг, нарийн шингэний менежмент, аюулгүй мембрануудтай, гэрийн хэрэглээнд ч хүртэл ашиглагддаг.
Колфф диализээр зогссонгүй. Хиймэл зүрх, зүрх-уушгины машин, биомедик инженерчлэлийн салбарт асар том хувь нэмэр оруулжээ.
Тэр 97 насандаа, 2009 онд таалал төгссөн. Харин тэр үед, түүний бүтээсэн технологи сая сая хүний амийг аварсаар байгаа билээ.
Колфф бидэнд дараах зүйлийг нотолж чадсан:
* Бөөрний үүргийг хиймлээр орлож болдог.
* Цусыг биеэс гадна цэвэрлэж болдог.
* Бөөрний дутагдал бол үхэл биш, эмчилгээний асуудал байж болох юм.
1943, N**i-occupied Holland: A doctor built the first dialysis machine from sausage casings and a washing machine drum. It saved millions of lives.
1943. Kampen, Netherlands.
The Netherlands had been under N**i occupation for three years. Food was rationed. Medicine was scarce. Hospitals operated under impossible constraints. Jewish doctors had been fired or deported. Medical supplies were requisitioned by German forces.
In the midst of this darkness, at a small hospital in Kampen, Dr. Willem Kolff faced a problem that had haunted physicians for centuries: kidney failure was a death sentence.
When a patient's kidneys failed—from disease, injury, or infection—toxins accumulated in their blood. There was no treatment. Doctors could only watch as patients became confused, then comatose, then died, usually within days or weeks.
Kolff had watched too many patients die this way. Young people. Parents. People who could have lived years longer if only there were a way to clean their blood—to do artificially what their kidneys could no longer do naturally.
He had an idea. A crazy, improvised, desperate idea.
What if he could build a machine to filter blood outside the body?
The concept was theoretically sound. Blood could be removed from the body, passed through some kind of filter that would let small waste molecules through while keeping blood cells and proteins in, then returned to the body clean.
But in 1943, in occupied Netherlands, with limited supplies and no precedent for such a device, how could it possibly be done?
Kolff started gathering materials. Not from medical supply companies—those were controlled by the Germans. From everyday sources. From whatever he could find.
He got cellophane tubing—the kind used for sausage casings. Cellophane is semi-permeable: tiny molecules can pass through it, but larger molecules cannot. It could theoretically act as an artificial kidney membrane.
He got a washing machine drum. If the cellophane tubing filled with blood was wrapped around a rotating drum and submerged in a bath of clean fluid, the rotation would expose the blood to fresh dialysate continuously, allowing waste products to diffuse out.
He scavenged spare parts: Metal frames. Tubes. Pumps. Whatever he could beg, borrow, or improvise from hospital equipment, spare parts, or junkyards.
And in 1943, in a hospital workshop in occupied Netherlands, Willem Kolff built the first functional artificial kidney machine.
It looked absurd. A wooden frame holding a rotating drum wrapped in cellophane tubing, submerged in a metal tank. Tubes running in and out. A pump to circulate blood. It looked more like a strange washing apparatus than a medical device.
But the theory was sound. And Kolff was desperate enough to try it.
His first attempts were failures. The machine worked mechanically, but patients didn't survive. There were complications—blood clotting, infections, technical problems. He refined the design. Adjusted the dialysate fluid. Improved the membrane.
He treated patient after patient, learning from each failure, making incremental improvements.
And then, in September 1945, just after the war ended, a 67-year-old woman named Sofia Schafstadt was brought to the hospital. She was in acute kidney failure, slipping into a coma from uremic poisoning—the buildup of toxins her kidneys couldn't filter.
She was dying. Hours or days left.
Kolff connected her to his machine. For eleven hours, her blood circulated through the cellophane tubing wrapped around the washing machine drum. Toxins diffused out of her blood through the membrane into the dialysate fluid.
When the treatment ended, Sofia regained consciousness. Her kidney function began to recover. She survived.
It was the first successful dialysis treatment in medical history.
Willem Kolff had proven that artificial kidney function was possible. That blood could be cleaned outside the body. That kidney failure didn't have to be a death sentence.
After the war, Kolff shared his invention freely. He didn't patent it or try to profit from it. He believed life-saving medical technology should be available to everyone. He sent blueprints and instructions to doctors around the world.
In 1950, he moved to the United States and continued his work at the Cleveland Clinic. He refined the dialysis machine. He trained other doctors. He pushed for the technology to be mass-produced and made available to hospitals.
By the 1960s, dialysis machines—still crude by modern standards but increasingly effective—were saving thousands of lives. By the 1970s, tens of thousands. Today, millions of people worldwide receive dialysis treatment, many of them for years or decades while waiting for kidney transplants or managing chronic kidney disease.
Modern dialysis machines are sophisticated medical devices with computerized controls, precise fluid management, and advanced membranes. They're used in hospitals and dialysis centers around the world. Some patients even have portable dialysis machines at home.
But every single one of those machines traces its lineage back to Kolff's original device: the one built from sausage casings, a washing machine drum, and spare parts in 1943 occupied Netherlands.
Willem Kolff didn't stop with dialysis. He went on to contribute to the development of artificial hearts—another impossible-seeming technology that became reality. He worked on heart-lung machines. He trained generations of biomedical engineers.
He received countless awards, including the prestigious Lasker Award (often considered the "American Nobel") and Japan's highest honor for foreign scientists.
But he always remained humble about his achievements. When asked about his work, he'd say simply: "I just wanted to help patients."
Willem Kolff died on February 11, 2009, at age 97. By then, dialysis had saved millions of lives and artificial organs were transforming medicine.
His obituaries called him the "father of artificial organs" and celebrated his contributions to medical technology.
But the most important statistic was this: millions of people alive because one doctor in occupied Netherlands refused to accept that kidney failure had to be fatal.
Kolff's story is a reminder that innovation doesn't require unlimited resources or perfect conditions. Sometimes it requires the opposite: constraints that force creative thinking.
He didn't have access to medical-grade materials, so he used sausage casings.
He didn't have sophisticated equipment, so he used a washing machine drum.
He didn't have a team of engineers, so he built it himself with spare parts.
And from those humble materials, he created technology that has saved more lives than most people can count.
His story proves that medical breakthroughs often come from seeing problems differently—from asking "what if?" when everyone else has accepted "it's impossible."
Today, when kidney failure is diagnosed, patients don't face a death sentence. They face a treatment plan. Dialysis buys time—sometimes years, sometimes decades—for kidneys to recover, for transplants to become available, or for patients to manage chronic disease and maintain quality of life.
Children born with kidney defects grow up. Young adults who develop kidney disease finish school, have careers, raise families. Elderly patients with kidney failure live to see grandchildren graduate.
All because in 1943, a Dutch doctor in N**i-occupied Netherlands looked at a sausage casing and a washing machine drum and thought: "I can save lives with this."
Willem Kolff's dialysis machine wasn't just a medical device. It was a testament to human ingenuity, determination, and the refusal to accept that people had to die simply because their kidneys stopped working.
It proved that sometimes the most important innovations come not from well-funded research laboratories, but from determined individuals working with whatever they have on hand, driven by the simple desire to help people.
1943: Sausage casings and a washing machine drum.
2024: Millions of lives saved.
That's the power of creativity, courage, and the belief that impossible problems might just have improvised solutions.
Willem Kolff showed the world that you don't need perfect tools to save lives. You need a perfect commitment to trying.
