Doctors at Northwestern Medicine in Illinois have achieved a medical first that could make organ transplants much less painful: They successfully performed a kidney transplant on a 28-year-old man without the use of general anesthesia. The operation went smoothly, and the man was released from the hospital within a day and is smoothly returning to his normal life.
of A groundbreaking step Late last month, John Nicholas, a Chicago resident, underwent a transplant. Nicholas was diagnosed with Crohn’s disease as a child and began showing signs of kidney problems when he was 16, but no underlying cause was found. He was able to stabilize his health with medication until 2022, when his kidney function began to decline significantly and he became eligible for a transplant.
Nicholas had no problem undergoing standard general anesthesia, but because he was young and healthy he was an ideal subject for an awake kidney transplant, and he agreed to undergo the procedure. For this operation, spinal anesthesia was used instead — the same type of anesthesia used for other surgeries, such as Caesarean sections — and the operation seemed to go without a hitch.
“Anesthesia for a conscious kidney transplant was easier than most C-sections,” said Dr. Garcia Thomas, chief of regional anesthesia and acute pain at Northwestern Memorial Hospital and a member of Nicholas’ surgical team. statement The hospital contacted us and said, “In John’s case, we administered a spinal anesthesia injection in the operating room and gave him a small amount of sedation for his comfort. It was very simple and without any issues, and John remained conscious throughout the procedure, improving the patient experience.”
In the end, the operation took less than two hours, and Nicholas was able to see his new kidney, donated by his best friend, just before it was inserted into his body. Nicholas received his kidney on May 24 and was released from the hospital the next day, although a typical transplant requires a two- to three-day hospital recovery period.
“It was an amazing experience to see what was happening in real time and realize the gravity of what they were doing,” Dr. Nicholas said in a statement. “At one point during the procedure, I remember asking, ‘Should I expect the spinal anesthesia to kick in?’ They had already performed so much surgery that I was completely unaware of the fact. I really didn’t feel anything.”
Nicholas has had to limit his salt intake for many years, but if his new kidney continues to function as expected, he will soon be able to enjoy foods like pizza again. With this initial success, the Northwestern team also plans to formally establish and expand the Accelerated Kidney Transplantation Without General Anesthesia (AWAKE for short) program for select patients. Not only will this program expand the pool of potential transplant patients, including those who cannot tolerate general anesthesia (some people have a strong fear of it, for example), but it may also result in shorter and safer transplant times overall for eligible patients.
“This really opens up a whole new door and adds another tool to our toolbelt in the transplant field,” Satish Nadig, a transplant surgeon and director of Northwestern Medicine’s Comprehensive Transplant Center, said in a statement.