John Nicholas, 28, is one of a select few patients to undergo a kidney transplant while fully conscious.
While he was on the operating table, doctors talked to him throughout the procedure, and at one point they even walked up to him to show him the new organs that were being implanted in his body to fix his kidney failure.
The Chicago man was released from the hospital within a day of the procedure and was able to recover at home, despite the average stay of five days for this type of surgery. Nicholas didn't even need opioid painkillers to recover.
Dr. Satish Nadig, director of Northwestern Medicine's Comprehensive Transplant Center and one of the surgeons who performed the operation, said doctors hope that successful awake surgeries like Nicholas's can reduce some of the risks associated with transplant surgery, such as breathing difficulties, blood loss, infection and death.
People with chronic illnesses such as diabetes, heart disease or lung disease are at higher risk of developing complications when put under anesthesia for surgery, which could make it harder for people who need new kidneys or other organs to receive them.
Dr Nadig explained that by partially paralysing a patient while they remain conscious, some of these risks are mitigated and “it's essentially an outpatient procedure.”
At the end of the operation, John Nicholas posed with the surgical team to celebrate a successful operation.
Nicholas was released from hospital the day after the operation and was walking around within a few days, saying he felt “back to normal”.
Nicholas Said “It was an incredible experience to see what was happening in real time and realize the magnitude of what they were doing,” said a Northwestern University press release.
“At one point during the operation, I remember asking, 'Should I expect the spinal anesthesia to kick in?' They had already performed many surgeries and I was completely unaware of the fact.
“I really didn't feel anything. I was sedated for my own comfort, but I still knew what they were doing, especially when they called my name and told me about some of the milestones they had achieved.”
Nicholas' kidney problems stem from a diagnosis of Crohn's disease when he was 16.
Crohn's disease affects more than 500,000 Americansaccording to Mayo ClinicConditions It involves frequent inflammation of the intestines and digestive tract, which can cause pain, diarrhea, fatigue and weight loss.
Doctors aren't sure how Crohn's disease affects the kidneys, but people with the disease appear to be at increased risk of developing kidney failure.
the study A survey by gastroenterologists at the Cleveland Clinic found that 8 percent of people with Crohn's disease or similar digestive disorders experience kidney problems, compared with 4 percent of people without the disease.
The kidneys are responsible for filtering blood and removing waste products from the body through urine. When the kidneys stop functioning, waste products build up in the body.
Initial symptoms include nausea, swelling, confusion, and fatigue. According to the Cleveland ClinicIf left untreated, it can eventually lead to kidney failure and death.
For years, Nicholas has managed his disease with medication and a strict diet, limiting his salt intake and giving up some of his favourite foods, including pizza.
But in 2022, during a routine checkup, doctors at Northwestern University told Nicholas that his kidneys were failing and he would need a kidney transplant.
His mother quickly volunteered to donate a kidney, but was diagnosed with breast cancer shortly thereafter and was no longer eligible to donate a kidney.
So Pat Wise, a 29-year-old childhood friend of Nicholas's from Virginia, offered to take her place.
Nicholas and donor Pat Wise had known each other since they were children, growing up in the Indianapolis suburb of Zionsville, when Wise decided to donate a kidney to his lifelong friend.
Nichols said she's looking forward to having more energy to do the things she loves, like riding her bike, and eating pizza again.
“John is a good friend. He needed a kidney and I had a spare kidney, so I needed to at least explore the possibility of being a donor for him,” Wise said.
Luckily, a match was found and Wise was able to fly to Chicago for surgery and donate a kidney to his best friend.
“We've always called ourselves 'till death do us part' friends and this just shows we have each other's backs. It means the world to me. It's truly life-changing,” Nicholas said.
Because humans have two of these vital organs, kidney transplants can be done as “living donor” organs. If you're healthy, you can live with just one kidney, as long as it's functioning properly.
Typically, healthy patients are put to sleep for the procedure under general anesthesia and have a tube inserted down their throat to help them breathe. It's usually a low-risk option, but rare complications can occur. Lung collapse and allergic reactions.
But many people with chronic illnesses such as diabetes, heart disease, high blood pressure and obesity are at higher risk of not waking up after being anesthetized, making any procedure riskier.
If you have any of these conditions, you may also be at higher risk of developing cognitive impairment or breathing problems during or after surgery.
During the operation, the surgeon showed Nicholas the kidney that was to be transplanted.
But in a procedure like Nicholas's, patients aren't put to sleep.
Instead, doctors can inject anesthesia directly into the patient's spine, much like during a C-section, allowing the patient to remain conscious throughout the procedure but not feel anything in the part of their body being operated on.
This allows the patient to continue breathing and regulating their heart rate on their own, Dr. Nadig said.
And the less often doctors interfere with normal functioning, the easier the patient usually recovers.
“I really think less is more,” Dr. Nadig says. Said Northwestern University press release.
He added: “Our hope is that awake kidney transplantation will reduce some of the risks of general anesthesia and shorten patients' hospital stays.”
The latest data available for 2021 shows that 25,550 kidney transplants Concerts were held in the United States and there was a waiting list for the organ with over 72,860 people.
Nicholas had no real risk factors that would prevent him from being put under anesthesia for surgery, and apart from impaired kidney function, he was considered to be in good health.
But the low risk was exactly why doctors decided to try the procedure on him, because he was more likely to be resilient than more unstable patients who might need it in the future.
While Nicholas may be the most recent patient, he is not the first to have the procedure.
A 63-year-old man from the UK In 2010, he underwent a kidney transplant while in a conscious state. Surgeons in India have been performing this technique on more than 40 patients over a period of more than a year. Four months in 2008.
However, this is the first time that Northwestern University doctors have performed the procedure in this way, and the university is considering building a program around the procedure.
It's unclear from the literature whether this has happened anywhere else in the U.S., but it's a first for Northwestern Hospital.
