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American surgeons performed a kidney transplant during which the patient remained awake. The latter was able to return home the next day. This world first could improve access to this type of transplantation for patients for whom general anesthesia is at risk, while reducing the length of stay for all transplant patients.
Beyond the technical prowess, this kidney transplant treated as an outpatient surgery could improve access to this type of transplant for patients who have previously had no solution. It also significantly reduces the length of hospitalization.
Nicholas’ best friend donates a kidney to him
At the age of 16, Nicholas began having kidney problems after being diagnosed with Crohn’s disease years before. Inflammation in his kidneys caused damage, although the root cause was never found. After moving to Chicago in early 2022, his kidney function declined and it became clear that he would need a kidney transplant.
He turns to his group of friends he’s known since elementary school, and his best friend, Pat Wise, 29, who works for a public health agency, has little hesitation: “I was in my kitchen trying to to cook dinner and John sent a message that said: “My doctor says it’s time for me to start looking for kidney donors.” I looked at my phone and, without hesitation, filled out the form that evening. John is a good friend. He had needed a kidney and I had one more I had to at least explore the potential of being his donor.“. Wise was found to be a match and traveled to Chicago, where surgeons removed one of his kidneys and transplanted it into Nicholas’s, in a novel procedure.
Awake surgery in less than 2 hours!
Nicholas had no risks or phobias to general anesthesia, but was an excellent candidate for the procedure due to his age, limited risk factors, and desire to participate in a medical first for Northwest Medicine .
On May 24 at Northwestern Memorial Hospital, Dr. Nadig, transplant surgeon and Vicente Garcia Tomas, anesthesiologist performed the operation which lasted less than two hours. The patient received a type of anesthesia similar to that used during a cesarean section. “In the operating room, it was an incredible experience to be able to show a patient what their new kidney looked like before placing it into the body” how the surgeon.
Technically, the anesthesiologist said the procedure was relatively simple: “In John’s case, we placed a spinal anesthesia injection in the operating room with some sedation for comfort. It was incredibly simple and uneventful, but allowed John to be awake for the procedure, improving the patient experience“. An enthusiasm shared by the patient himself: “It was a pretty cool experience knowing what was happening in real time and being aware of the magnitude of what they were doing“.
A patient returned home the next day
After successful surgery on May 24, Nicholas was discharged the next day and left the hospital on May 25. The normal hospitalization for patients who undergo a kidney transplant at this prestigious American hospital is usually 2 to 3 days. Before the transplant, Nicholas had to limit his salt intake, but now he looks forward to enjoying pizza and having more energy to ride his bike around Chicago.
In the future, Northwestern Medicine will seek to establish the AWAKE (Expedited Surgery Without General Anesthesia in Kidney Transplant) program for a particular subset of patients who desire surgery, cannot undergo general anesthesia, or are at risk high general anesthesia, or fall into a category where it could benefit the patient.
“This truly opens a whole new avenue and is a new offering in the field of transplantation” said Dr. Nadig, a transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center.