Originally published in Volume 35 Issue 2 of Artificial Organs, 16 February 2011

The field of artificial organs has had a very rich history of accomplishments that we have all benefited from as researchers, developers, clinicians, corporations, and most importantly patients. The field is a unique blending of the disciplines of various medical disciplines, the physical, chemical, and biological sciences, and all engineering disciplines. From my point of view, the field of modern-day artificial organs had its start with the first clinical application of the artificial kidney for acute renal failure by Dr. Wilhelm Kolff in 1943, less than seven decades ago. Taking this example, Dr. Kolff had to bring together various scientific and medical concepts, recognize the clinical need and scientific approach, and clinically carry out the procedures. The artificial kidney, and in particular hemodialysis, depended on the principles of dialysis that had been discovered nearly 80 years prior by Graham; the anticoagulation of blood for extracorporeal circulation was reported decades before and utilized by Abel, Roundtree, and Turner on dogs; the use of a synthetic membrane that was derived from cellulose and used for sausage casings; and the design and development of a very large “machine” to interface with the patient. Similar scenarios exist also for other artificial organ technologies including other renal support processes; blood detoxification systems; pump technologies for cardiac support; gas exchange technologies for pulmonary support; mechanical/biomaterial systems for orthopedic and dental support; biological constructs for orthopedic, neuromuscular, liver, and pancreatic support; material systems for vascular support and blood replacement; and electronic systems for visual, orthopedic, and neuromuscular support and device power, sensing, and control. Clearly the application or technology requires the integration of various means to achieve a successful outcome. As with constructing a building, medical/scientific procedures and devices are developed from a foundation and then built up brick by brick by the contributions from various individuals. Certainly the legacy of this field has depended on the efforts of many but also on the pioneering efforts of some.

Our history has also demonstrated that the pioneers in this field are not silenced or hindered by their failures. In fact, failure has been at times a prescription for defining new approaches and new directions. “Artificial organists” are not put down by failures and critics. When Dr. Kolff started his clinical work on clinical dialysis, the first life-saving case was on patient number 17. Pioneers can be stubborn. They possess a strong belief in what they are doing and do not give up easily. They may carry the battle scars of their efforts, but they are also resilient. Those who follow them are respectful of their accomplishments.

While the pages of this journal are filled with peer-reviewed reports of new studies on various topics in the field, we would like to hear from our pioneers on their perspectives. To do so we have initiated this Pioneer Editorial Series and expect from time to time to hear their perspectives. We are appreciative to Dr. Bill Pierce for taking on this challenge and providing this first contribution.

Paul S. Malchesky DEng