What if a major transplant surgery could have the same convenience as an outpatient procedure? Surgeons at Northwestern Medicine now have a better idea of the potential benefits after delivering a new kidney without using general anesthesia—and being able to discharge the patient the next day.
According to the health system, 28-year-old John Nicholas of Chicago felt no pain after surgeons injected anesthesia into his spinal column to block nerve signals from the incision site—similar to what is used during a C-section birth—and that he was conscious for the entire procedure, with only mild sedation for comfort.
“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,” Satish Nadig, director of Northwestern’s transplant center, said in a statement.
The surgeons said they believe this approach could open up the possibility of transplants to patients where pursuing general anesthesia may be too risky. Nicholas was previously diagnosed with Crohn’s disease as a teenager, and inflammation within the kidneys began to limit their function. One of his best friends from childhood donated their organ for the procedure in late May.
“We always called ourselves ‘ride or die’ friends, and this example shows that we have each other’s backs. It meant the world to me. It’s truly been life-changing,” Nicholas said. “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.”
While Nicholas did not have any risks related to anesthesia, the health system described him as a prime candidate to be the first to undergo the procedure due to his relatively young age and comparatively good health.
Going forward, surgeons at Northwestern Medicine plan to launch the AWAKE Program, for Accelerated Surgery Without General Anesthesia in Kidney Transplantation. They said it could serve patients who can’t receive general anesthesia, as well as those who may have a phobia of being put under.
“It really opens up a whole new door and is another tool in our toolbelt for the field of transplantation,” said Nadig.