Innovative Procedure Marks a Milestone
Surgeons at Northwestern Medicine achieved a groundbreaking milestone by performing a kidney transplant on an awake patient. This first-of-its-kind procedure for the Chicago-based healthcare system involved 28-year-old John Nicholas, who experienced no pain during the May 24 operation and was discharged the following day, a stark contrast to the typical 2-3 day hospital stay post-transplant at Northwestern Memorial Hospital.
Patient’s unique experience
“It was a pretty cool experience to know what was happening in real time and be aware of the magnitude of what they were doing,” Nicholas said in a news release. He added that he felt “no sensation whatsoever” despite being awake and aware due to a sedative used for comfort. “Especially when they called out my name and told me about certain milestones they had reached.”
Innovative anesthesia approach
Instead of the usual general anesthesia, doctors opted for a single-spinal anesthesia shot, similar to those used during cesarean sections. “Inside the operating room, it was an incredible experience being able to show a patient what their new kidney looked like before placing it inside the body,” said Dr. Satish Nadig, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center.
Nadig highlighted the potential benefits of this approach: “The patient was able to be discharged home in less than 24 hours, basically making this an outpatient procedure. Our hope is that awake kidney transplantation can decrease some of the risks of general anesthesia while also shortening a patient’s hospital stay.”
This procedure may also provide increased accessibility for patients at higher risk of complications from general anesthesia. Nicholas was an ideal candidate due to his age, limited risk factors, and willingness to participate in a medical first.
Nicholas’s kidney issues began at 16 following a diagnosis of Crohn’s disease. After managing his condition with medication for years, his kidney function declined in early 2022, necessitating a transplant. With his mother unable to donate due to a breast cancer diagnosis, Nicholas’s childhood best friend, 29-year-old Pat Wise, stepped in as a donor match.
“We always called ourselves ‘ride or die’ friends, and this example shows that we have each other’s backs. It meant the world to me. It’s truly been life-changing,” Nicholas said, expressing his excitement for resuming activities like bicycle rides and enjoying pizza without dietary restrictions.
Future of awake transplants
Northwestern Medicine is now aiming to establish the AWAKE Program (Accelerated Surgery Without General Anesthesia in Kidney Transplantation) for other patients seeking a similar procedure. “It really opens up a whole new door and is another tool in our toolbelt for the field of transplantation,” Nadig stated.