Surgeons at Northwestern Medicine performed a kidney transplant on an awake patient for what is believed to be the first time in the United States.
The patient, 28-year-old John Nicholas of Chicago, felt no pain during the May 24 procedure and was discharged the next day. Typically a patient is hospitalized for 2-3 days following a kidney transplant at Northwestern Memorial Hospital.
“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, adding he felt “no sensation whatsoever.” “I had been given some sedation for my own comfort, but I was still aware of what they were doing. Especially when they called out my name and told me about certain milestones they had reached.”
Instead of normal general anesthesia, doctors used a single-spinal anesthesia shot, which is similar to what’s used during cesarean sections.
“To our knowledge, this is the first known case in the United States where a patient was awake during an entire kidney transplant procedure. 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,” Dr. Satish Nadig, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center, said in the release.
José M. Osorio
The other exciting element? “The patient was able to be discharged home in less than 24-hours, basically making this an outpatient procedure,” Nadig said. “Our hope is that awake kidney transplantation can decrease some of the risks of general anesthesia while also shortening a patient’s hospital stay.”
It may also offer increased accessibility for those who are at higher risk to undergo general anesthesia.
While this wasn’t the case for Nicholas, he was a candidate thanks to “his age, limited risk factors and eagerness to participate in a medical first,” according to the release.
Nicholas began having kidney issues at 16 after being diagnosed with Crohn’s disease years prior. Though he was able to manage his condition for years with medication, in early 2022 his declining kidney function made it clear he would need a transplant.
With his mom unable to donate following a breast cancer diagnosis, his childhood best friend, 29-year-old Pat Wise, didn’t hesitate to fill out a donor form and was declared a 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, who added he’s looking forward to having more energy for bicycle rides and enjoying pizza after having to previously limit his salt intake.
José M. Osorio
Now Northwestern Medicine is looking to establish the AWAKE Program (Accelerated Surgery Without General Anesthesia in Kidney Transplantation) for other patients who want a similar operation.
“It really opens up a whole new door and is another tool in our toolbelt for the field of transplantation,” Nadi said.
