ZBYLUT J. TWARDOWSKI

Paul Teschan, MD, is this year’s winner of the Annual Award for Lifetime Achievements in Hemodialysis. Born in Milwaukee, Wisconsin, on December 15, 1923, he graduated from high school as valedic-torian in 1942. Because of World War II, he studied on an 'accelerated schedule' at Carleton College, then at the University of Minnesota Medical School. He graduated in 1948 and received a MS degree in physiology the same year.

Dr. Teschan joined the Army Medical Service in 1948 and, as an active-duty medical officer, completed his internship and residency in Chicago. During this time he also com-pleted a short fellowship at Peter Bent Brigham Hospital in Boston, Massachusetts (for the training of medical officers in acute renal failure and dialysis), where he became acquainted with the Kolff-Brigham rotating-drum dialyzer.

After his residency, Dr. Teschan worked as a Ward Officer at the Walter Reed Army Institute of Research in Washington, DC. In 1952, at the height of the Korean War, he became the Chief of the Renal Center of the U.S. Army in Korea. The Renal Center acquired a Kolff-Brigham dialyzer in April 1952, and provided dialysis for acute renal failure in combat casualties.

In 1954 he became Chief of the Renal Branch at the U.S. Army Surgical Research Unit of Brooke Army Medical Center in Fort Sam Houston, San Antonio, Texas, and served in this position until 1960. While Dr. Teschan was working in Fort Sam Houston, the Renal Branch acquired the McNeill-Collins dialyzer. This dialyzer had substantial advantages over the Kolff-Brigham: hydrostatic ultrafiltra-tion was possible, only 250 mL of blood was required to fill the dialyzer and lines, and no pump was necessary because of low internal resistance.

At that time Dr. Teschan contemplated the introduction of 'prophylactic daily hemodialysis'; however, this would be a substantial departure from the established practice at that time. Dr. Teschan convened a closed meeting of experts in acute renal failure and dialysis. The continuing unsatisfactory experiences with patient morbidity and mortality were shared and confirmed among the participants. This situation impelled the 'paradigm shift' to develop 'prophylactic daily dialysis.' Shortly thereafter, Dr. Teschan and his colleagues Drs. O’Brien and Baxter, reported excellent results with prophylactic daily dialysis in acute renal failure due to various surgical and traumatic causes.

From 1961 to 1969, Dr. Teschan held various positions at the Walter Reed Army Institute of Research in Washington, D.C. From 1963 to 1964 he served in the rank of the lieutenant colonel as a Chief of the U.S. Army Medical Research Team (WRAIR) in Vietnam. While in Vietnam, Dr. Teschan rendered medical care to Field Marshal Sarit Thanarat, Prime Minister of Thailand. For this service he was decorated with the Most Noble Order of the Crown of Thailand. After returning from Vietnam he was promoted to full bird colonel and he served simultaneously as a Consultant in Renal Diseases to the Surgeon General, Department of the Army.

In 1969 Dr. Teschan retired from the Army and began a second career as a Professor of Medicine at the Vanderbilt University in Nashville until 1993. Between 1977 and 1989 he also served as the Co-Medical Director of Dialysis Clinics, Inc., Nashville, Tennessee. Excellent results of prophylactic daily dialysis in acute renal failure inclined him to explore the possibility of using daily dialysis in chronic renal failure. He convened a group of experts at the ASAIO Meeting in 1980. As a result of discussion, the participants concluded that daily dialysis was not routinely indicated in acute or chronic renal failure, but would be beneficial in special circumstances. For chronic daily dialysis, the home setting was postulated with the indefinite reuse of components.

Throughout his career Dr. Teschan always championed patients’ interests. In 1967 he received the Prefix A to Military Occupational Specialty for Outstanding Qualification in the Field of Internal Medicine. More than 170 published original papers, editori-als, monographs, and chapters, pri-marily related to dialysis, and general nephrology, are the result of his clini-cal research. His main areas of interest have been related to the pathogenesis and prevention of acute renal failure, including prophylactic dialysis, causes of uremia, nutrition in chronic renal failure, and interventions in progres-sive renal failure.