Thursday, June 27, 2024

Drive through awake kidney transplant

Kidney transplants are not uncommon — the kidney is actually the most frequently transplanted organ in the U.S. — but a Chicago man recently received his in a highly unusual way.

John Nicholas, 28, was awake during the entire procedure, which was performed on May 24 at Northwestern Medicine Hospital. He was discharged the very next day.

Doctors administered a spinal anesthesia shot — similar to what is used for a Cesarean section — instead of general anesthesia, according to a press release from the hospital.

"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, basically making this an outpatient procedure," said Satish Nadig, M.D., PhD, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center, in the release.

"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," he added.

"It was incredibly simple and uneventful."

This type of "awake transplant" could reduce surgical risks and shorten the length of the patient’s hospitalization, doctors say.

"It was an incredible experience, being able to show a patient what their new kidney looked like before placing it inside the body."

It could also increase access to care for patients who are considered high-risk or have phobias surrounding general anesthesia.

He was considered an ideal patient for awake surgery due to his young age, his otherwise good health and his "eagerness to participate," per the release.

"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," said Nicholas in a statement to Northwestern.

"At one point during surgery, I recall asking, ‘Should I be expecting the spinal anesthesia to kick in?’ They had already been doing a lot of work and I had been completely oblivious to that fact. Truly, no sensation whatsoever."

Although Nicholas did receive sedation for comfort, he said he was still aware of what was going on.

"Especially when they called out my name and told me about certain milestones they had reached," he noted.

Nicholas walked out of the hospital on May 25, the day after surgery.

Nicholas’ kidney issues began at age 16 when he was diagnosed with Crohn’s disease, the release stated.

After a few years of managing the condition with medication, his kidney function worsened and he required a transplant.

Nicholas’ mother originally planned to donate her kidney, but a breast cancer diagnosis prevented her from doing so, the hospital relayed.

It was Nicholas’ best friend from elementary school, 29-year-old Pat Wise in Alexandria, Virginia, who ultimately donated the life-saving kidney.

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in the surgery but shared his input.

"My opinion is that in most cases, spinal anesthesia presents a reasonable alternative for those at high risk of general anesthesia complications," Siegel told Fox News Digital.

"Having said that, general anesthesia would be preferred whenever possible for major surgery like this," said Dr. Siegel, "because control of the airway and breathing is essential, and is much easier if the patient is asleep and on the ventilator."

The doctors at Northwestern credit the patient for helping to advance the field of transplant medicine.

"When John agreed to be the first known patient at Northwestern Medicine to undergo an awake kidney transplant and be discharged home the next day, he knew the benefits outweighed the risks, and … he’s now helping to move the field of transplantation forward," said Vinayak Rohan, M.D., transplant surgeon at Northwestern Memorial Hospital, in the release.

"He is an extremely compliant patient who was in tune with his body and willing to push the envelope," stressing that the patient had faith in the doctors and they, in turn, had faith in him.

The hospital now plans to establish the AWAKE Program (Accelerated Surgery Without General Anesthesia in Kidney Transplantation) for patients who want or need to pursue surgery without general anesthesia.

"It really opens up a whole new door and is another tool in our toolbelt for the field of transplantation," Nadig added.

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