A medical team in the United States has performed a rare kidney transplant during which the patient was awake throughout the procedure and was discharged the next day.
John Nicholas, from Indianapolis, underwent the awake transplant last month at the Northwestern Memorial Hospital in Chicago. His childhood friend, Patrick Wise, whom he has known since elementary school was the live donor.
Instead of using a general anesthesia, which requires the patient to be intubated, doctors used a spinal epidural shot, which is a regional anesthesia also used during a C-section or a routine colonoscopy.
Nicholas told Global News that seeing his friend’s kidney before they put it in was “pretty amazing.”
“They showed me the kidney before they put it in. I don’t think anybody’s ever had that experience before.”
The doctors even asked what kind of music he would like to listen to during the procedure. Nicholas picked The Killers, one of his favourite bands.
“At the beginning, I was actually singing along to that,” he said, smiling.
U.S. kidney recipient John Nicholas with the transplant team after his surgery at the Northwestern Memorial Hospital in Chicago, Illinois, on May 24, 2024.
Photo provided by Northwestern Medicine
Since a blind was hung up around his neck area, Nicholas, who was fairly drowsy because of a mild sedative, couldn’t actually see the surgery in real time, but he could still hear the surgeons as they interacted with him step-by-step how the transplant was going. The operation took less than two hours.
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“I didn’t experience any pain,” Nicholas said. “I had no sensation at all during the surgery.
“Most of my experience during the surgery was hearing the surgeon call out that various milestones had happened during the surgery.”
Pictured here from the left: Vicente Garcia Tomas, anesthesiologist at Northwestern Memorial Hospital, kidney recipient John Nicholas and Satish Nadig, transplant surgeon and director of Northwestern Medicine Comprehensive Transplant Center.
Photo provided by Northwestern Medicine
This is not the first awake kidney transplant that has been performed in the U.S.
Satish Nadig, chief of transplant surgery at Northwestern Medicine, who performed the operation said Nicholas did not require any opioid narcotic pain medication and was able to go home within 24 hours of the procedure with a functioning kidney.
Being in constant communication with the transplant team, Nicholas was a “participant in the operation rather than just a spectator in his own health care,” Nadig told Global News in an interview.
He said this “paradigm-shifting” procedure could pave the way for transplant access for patients who are at high-risk to undergo general anesthesia, while also shortening the length of hospital stay for a transplant patient.
“We thought at Northwestern that we could make a major operation into an overnight procedure,” he said.
“Now that John’s broken the ceiling, we can offer it to patients who have lung disease, or are older or have heart disease that may pose a higher risk for general anesthesia to make a recovery for them much safer,” Nadig said.
Nicolas was first diagnosed with chronic kidney disease during high school in 2013. After moving to Chicago in 2022, his kidney function had deteriorated and doctors at Northwestern told him he needed to get a transplant.
The Northwestern team picked him as a candidate for the awake transplant because he was young, otherwise healthy and also willing to go ahead with it.
“We were trying to make a good operation, which kidney transplantation traditionally done, is a good operation, better – and he was on board with that,” Nadig said.
One month since the transplant, Nicholas said his recovery “has gone extremely well.”
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