A 28-year-old American man received a new kidney transplant while he was awake during the procedure and was able to watch his own operation.
- John Nicholas received a kidney from a childhood friend last May.
- The special thing about his operation was that he was awake during the entire procedure, under spinal anesthesia instead of general anesthesia.
- Thanks to this less severe anesthesia, he was able to return home less than 24 hours after the transplant.
John Nicholas, a 28-year-old American who developed kidney problems due to his Crohn’s disease, received a kidney transplant from his childhood friend Pat Wize on May 24, 2024. While this selfless gesture is very touching, another element gives an even more impressive scope to this story.
The transplant patient was not asleep during the operation, performed by doctors at Northwestern Medicine (Chicago), and was back home less than 24 hours after surgery.
Awake transplant: reducing the risks of general anesthesia
Nicholas began suffering from kidney problems at the age of 16. It was a complication of his Crohn’s disease, diagnosed a few years earlier. His kidney function gradually declined. To the point that in 2022, the option of a kidney transplant was put forward by his nephrologist. When looking for a compatible donor, his childhood friend immediately volunteered.
That’s when the Northwestern Medicine team suggested Nicholas have the transplant done, not under general anesthesia, but under spinal anesthesia. This is a method similar to that used during cesarean sections. The drug is injected into the spinal fluid at the level of the lumbar vertebrae.
“This is the first case at Northwestern Medicine where a patient was awake during an entire kidney transplant procedure and went home the next day, making it essentially an outpatient procedure. Our hope is that awake kidney transplantation can reduce some of the risks of general anesthesia, while also shortening a patient’s hospital stay.”explains Dr. Satish Nadig, a transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center, in a communicated published on June 24.
“In the operating room, it was an incredible experience to be able to show a patient what their new kidney looked like before it was placed in the body.”adds the expert.
Awake kidney transplant: “It was a pretty cool experience…”
And the experience does not appear to have been traumatic for Nicholas. “It was a pretty cool experience to know what was happening in real time and to be aware of the magnitude of what they were doing, confides the patient. At one point during the surgery, I remember asking, “Should I expect the spinal to kick in?” They had already done a lot of work and I was completely unaware of it. Really, no sensation. I was sedated for my own comfort, but I was still aware of what they were doing. Especially when they called my name and told me about some of the steps they had taken.”
In addition to being a solution for people with risks or a phobia of general anesthesia, this method has an advantage: it helps shorten the hospital stay after the procedure. Nicholas was, in fact, discharged the day after his transplant, while the stay for this type of procedure is usually 2 to 3 days with general anesthesia.
Following this first within its walls, the American hospital plans to launch a program, called AWAKE. The latter will offer patients – for whom it could be beneficial – to use spinal anesthesia, rather than general. However, it will only be available for kidney transplants at first. “This really opens a whole new door and is another tool in our toolbox for the transplant field,” concludes Dr Satish Nadig.
For the first time @NorthwesternMedsurgeons performed a kidney transplant where the patient was awake during the entire surgery and was discharged home the next day.
PRESS RELEASE: https://t.co/zeIIdxU9z9 @NM_Transplant pic.twitter.com/pGeUTOlToZ
— NM Media Relations (@NMHC_News) June 24, 2024
