Doctors perform kidney transplant on awake patient, who is out of hospital in 1 day

Kidney transplants are usually done with a patient fully unconscious under general anesthesia.
Dr. Tomas, John and Dr. Nadig
Posted at 2:43 PM, Jun 24, 2024

Doctors at Northwestern Memorial Hospital in Chicago have performed a kidney transplant on a patient who was awake the whole time.

They say the technique used updated anesthesia methods which may now be used for more patients who would be considered too risky to go fully under, which is the standard now.

The patient, 28-year-old kidney disease patient John Nicholas, paves the way for more patients who are older and have more risks.

"There are a lot of people that have heart and lung disease that also need a kidney transplant, and that just increases the risk of general anesthesia even more," Dr. Satish Nadig, Comprehensive Transplant Center director and chief of abdominal transplant surgery at Northwestern Memorial Hospital in Chicago told Scripps News.

"There's a lot of people out there [and] they're very high risks for intubation, meaning getting a tube put into their throat to help them breathe. Very high risk for being on a ventilator. A lot of older people that need kidney transplants get cognitive or neurologic issues after general anesthesia," said Dr. Nadig.

Right now, kidney transplants are usually done with a patient fully unconscious under general anesthesia. In Nicholas' case, doctors used a spinal shot, also used in abdominal and pelvic surgeries like cesarean sections to deliver babies.

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"Doing anesthesia for the awake kidney transplant was easier than many C-sections," Dr. Vicente Garcia Tomas, chief of regional anesthesiology and acute pain medicine at Northwestern Memorial Hospital said in a press release. "For John's case, we placed a spinal anesthesia shot in the operating room with a little bit of sedation for comfort. It was incredibly simple and uneventful, but allowed John to be awake for the procedure.

Being awake meant no invasive ventilator, and Nicholas used his own lungs. He could breathe, talk and interact with doctors. Other benefits include a shorter procedure and a faster and smoother recovery.

"He required zero opioid or narcotic pain medication. He was asking to eat, even during the surgery. That was a question he asked me while we were sewing the kidney in: 'When can I eat?'" Nadig said.

Nicholas went home after just one night in the hospital following his transplant, which is much shorter than the typical several days to a week post-kidney transplant.

That lowers the chance for complications. Research shows infection, bed sores, and bad drug reaction risk goes up the longer someone stays in the hospital.

Next, Nadig says they've identified five more patients for awake kidney transplants, opening the door to those considered too risky for general anesthesia.