In a groundbreaking procedure, a 28-year-old Chicago resident received a kidney transplant while remaining awake throughout the surgery. John Nicholas underwent a successful operation at Northwestern Medicine on May 24th.
Nicholas reported feeling no pain during the procedure and was discharged from the hospital a mere 24 hours later. This represents a significant reduction in typical hospital stays for kidney transplant patients, which can range from 2-3 days at Northwestern to a national average of 7 days.
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The key to the minimally invasive surgery was the use of a spinal anaesthetic, similar to what is used during caesarean sections, instead of general esthesia. Dr Satish Nadig, the transplant surgeon, stated in a press release that keeping Nicholas awake allowed the surgery to be conducted on an outpatient basis.
As per the release, Dr Nadig, Vinayak Rohan, MD, transplant surgeon at Northwestern Memorial Hospital, and Vicente Garcia Tomas, MD, anesthesiologist and chief of regional anesthesiology and acute pain medicine at Northwestern Memorial Hospital, performed the surgery, which took less than two hours. The patient received a type of anaesthesia that's similar to what's used during a caesarean section.
"Doing anaesthesia for the awake kidney transplant was easier than many C-sections," said Dr Garcia Tomas. "For John's case, we placed a spinal anaesthesia shot in the operating room with a little bit of sedation for comfort. It was incredibly simple and uneventful, but it allowed John to be awake for the procedure, improving the patient experience. Not only can awake kidney transplantation help patients who have risks or phobias to general anaesthesia, but it can help shorten their hospital stay so they can recover more comfortably at home."
Nicholas didn't have any risks or phobias about general anaesthesia but was a great candidate for the procedure due to his age, limited risk factors, and his eagerness to participate in a medical first for Northwestern Medicine.
"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. "At one point during surgery, I recall asking,'should I be expecting the spinal anaesthesia to kick in?' They had already been doing a lot of work, and I had been completely oblivious to that fact. Truly, there is no sensation whatsoever. I had been given some sedation for my own comfort, but I was still aware of what they were doing. Especially when they called out my name and told me about certain milestones they had reached."
After a successful surgery on May 24, Nicholas was discharged the next day and walked out of the hospital on May 25. The normal hospitalisation for patients who undergo a kidney transplant at Northwestern Memorial Hospital is typically 2-3 days.
