John Nicholas, 28, has just become one of the few patients to receive a kidney transplant while fully awake.
His doctors talked to him throughout the procedure as they skinned his abdomen on an operating table. At one point, they even came over to show him the new organ that would be placed inside his body to cure his kidney failure.
Less than a day after surgery, the Chicago man was released from the hospital to recover at home, despite the average hospital stay of five days for this type of procedure. Nicholas didn’t even need opioid painkillers to recover.
One of the surgeons in the case, Dr. Satish Nadig, director of Northwestern Medicine’s Comprehensive Transplant Center, said doctors hope the success of awake surgeries like Mr. Nicholas’s can reduce some of the surgery’s risks. transplant, including breathing problems, blood problems, and 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 to sleep for surgery, which can make it more difficult for those who need to get a new kidney or other organ.
Keeping patients awake while a part of their body is numbed reduces some of these risks, Dr. Nadig explained, “basically making this an outpatient procedure.”
At the end of the surgery, John Nicholas posed with his surgical team to celebrate the successful procedure.
Nicholas was released from the hospital a day after his operation and said that within a few days he was walking and feeling “back to normal.”
Mr. Nicholas saying in a Northwestern news release: ‘It was a cool experience knowing what was happening in real time and being aware of the magnitude of what they were doing.
“At one point during the surgery, I remember asking, ‘Should I wait for the spinal anesthesia to take effect?'” They had already been working hard and I had been completely oblivious to that fact.
‘In truth, there is no sensation at all. They had administered a sedative for my comfort, but I was still aware of what they were doing. Especially when they shouted my name and told me about certain milestones they had achieved.’
Mr. Nicholas’ kidney problems stemmed from a diagnosis of Crohn’s disease when he was 16 years old.
Crohn’s disease affects more than half a million Americansaccording Mayo Clinic. The condition It involves frequent inflammation of the intestine and digestive tract, which can cause pain, diarrhea, fatigue and weight loss.
Doctors aren’t clear how Crohn’s disease affects the kidneys, but people with the disease appear to have a higher risk of developing kidney failure.
Investigation Gastroenterologists at the Cleveland Clinic found that eight percent of people with Crohn’s disease or a similar gastrointestinal disease experience kidney problems, compared with four percent of people without the disease.
The kidneys are responsible for filtering the blood and removing waste from the body through urine. If your kidneys stop working, waste builds up in your system.
This initially causes nausea, bloating, confusion and fatigue, according to the Cleveland Clinic. Over time, if left untreated, it can lead to kidney failure and be fatal.
For years, Nicholas was able to control the disease through medication and a strict diet, limiting his salt intake and giving up some of his favorite foods, such as pizza.
But in 2022, during a routine checkup, Northwestern doctors told Nicholas that his kidneys were getting worse and he would need a transplant to replace them.
Her mother quickly volunteered to donate her kidney, but soon afterward she was diagnosed with breast cancer and was no longer eligible to donate.
Then Nicholas’ childhood friend, Pat Wise, 29, who lives in Virginia, offered to take his place.
Nicholas and Pat Wise, his donor, have known each other since they were children growing up in an Indianapolis suburb called Zionsville. Wise decided to donate his kidney to his lifelong friend.
Nichols said he hopes to have more energy to do the things he loves, like riding his bike. He also really wants to eat pizza again.
Mr Wise said: ‘John is a good friend. He needed a kidney and I had an extra one. I had to at least explore the potential of being his donor.’
Fortunately, it was a match and Wise was able to donate his kidney to his best friend after flying to Chicago for the surgery.
“We’ve always called each other ‘ride or die’ friends, and this example shows that we support each other. It meant a lot to me. It’s really changed my life,” Nicholas said.
Kidney transplants can be performed as “living donations” because humans have two of these crucial organs and, if you are healthy, you can live with just one kidney, as long as it works properly.
Under typical circumstances, healthy patients are put to sleep for surgery with general anesthesia and a tube is placed down their throat to help them breathe. This is generally a low-risk option, although it has the potential for rare complications. such as lung collapse and allergic reactions.
But many people who suffer from chronic conditions, such as diabetes, heart disease, high blood pressure or obesity, have a higher risk of not waking up after having undergone it, making any procedure higher risk.
Having any of these conditions could also increase your risk of developing cognitive dysfunction or breathing problems during or after surgery.
Surgeons showed Mr Nicholas the kidney that was to be transplanted into his body during the surgery.
However, in a practice like Mr. Nicholas’s, patients are not put to sleep.
Instead, doctors can inject a numbing agent directly into the patient’s spine, as is done in C-sections, allowing them to remain awake during the procedure but not feel anything in the part of the body undergoing surgery.
This allows the patient to continue breathing on their own and regulate their own heart rate, Dr. Nadig said.
And the less doctors interfere with those normal functions, the easier it will be for the patient to recover.
“I really feel like less is more,” Dr. Nadig saying in a Northwestern news release.
He added: “Our hope is that awake kidney transplantation can decrease some of the risks of general anesthesia while shortening the patient’s hospital stay.”
In 2021, the latest data available, 25,550 kidney transplants They were carried out in the United States and 72,860 more people were on the waiting list for the organ.
In reality, Mr. Nicholas did not have any risk factors that would prevent him from sleeping for surgery. Aside from his kidney dysfunction, he was considered to be in good health.
But it was the fact that he was low risk that doctors decided to try this procedure on him, as he was probably more resilient than less stable patients who might require it in the future.
While Mr. Nicholas may be the most recent, he is not the first patient to have the procedure performed.
A 63-year-old man in the United Kingdom received a kidney transplant while awake in 2010. And Indian surgeons have performed this technique on more than 40 patients over a period of time. four month period in 2008.
But this is the first time Northwestern doctors have performed the procedure this way and they said they are looking to develop a program around it.
It is unclear from the literature whether this has happened anywhere else in the United States, but it is a first for Northwestern hospitals.