Northwestern surgeons perform one of the first 'awake' kidney transplant surgeries

Surgeons at Northwestern Medicine performed one of the first awake kidney transplants last month.

Dr. Satish Nadig, one of the transplant surgeons and director of the Northwestern Medicine Comprehensive Transplant Center, along with transplant surgeon Dr. Vinayak Rohan and anesthesiologist Dr. Vicente Garcia Tomas performed the surgery in less than two hours, according to a press release from Northwestern Medicine.

The patient, 28-year-old Chicago resident John Nicholas, was released within 24 hours of the procedure — a day or two faster than the normal release time for patients under general anesthesia; in addition, he didn't require prescription narcotics afterward. He also didn't have to be put on a ventilator to keep him breathing.

Instead, he was given a spinal anesthetic to numb him from the chest down, similar to what is done in C-sections. Doctors say ventilators and general anesthetics could have extended his recovery time.

“Grading on the curve that I was having surgery, it was pretty easy,” Nicholas told the Sun-Times. “It was very powerful. … It was just a very surreal experience.”

Nicholas, who has Crohn's disease, required a new kidney after inflammation in his kidneys damaged their ability to function, he said. Initially his mom had been set to be the donor, but after she was diagnosed with breast cancer, Nicholas had to keep searching. A childhood friend was a match.

The doctors then proposed the new approach, citing Nicholas' otherwise good health and his background studying biomedical engineering as reasons why he was a good candidate.

“It’s exciting for us [because] the patient becomes a participant in the healing of their own disease process,” Nadig said. “For them to have a front-row seat in the curing of their own ailments is incredible.”

Nicholas said he has since been able to eat with fewer restrictions. He even enjoyed a slice from Pizza Lobo, and he was able to ride his bike again.

“This is life transformation and to be part of it … it’s amazing,” Rohan added.

The innovative procedure has been in the works for several years, but the trio of doctors really focused on making it a reality in the last year.

Nadig said that because kidney transplants have been done the same way for several decades, there’s “a lot of resistance to change” in the field. He said his team was “just interested in making it better.”

“There’s a lot of room for this, it’s a young field,” Nadig told the Sun-Times. “We want to challenge the status quo and figure out how we can do it better.”

“Innovation and moving the field forward, aside from patient outcome, is what drives us forward,” Rohan added.

Not only does awake transplant surgery improve recovery time, but it also “shatters a glass ceiling” for people with heart or lung conditions that can make kidney transplants difficult or impossible.

Northwestern Medicine is now hoping to establish the AWAKE program — Accelerated Surgery Without General Anesthesia in Kidney Transplantation — to widen use of the procedure.

Garcia Tomas said he hopes it not only allows physicians to gain more expertise by doing more of these surgeries, but also that it emboldens other surgical centers to offer the procedure.

“We’re in the very nascent period for this program, but we’re always working toward the same goal of improving patient care and outcomes,” Garcia Tomas said. “It potentially opens the door for a whole new way of thinking and approaching these surgeries.”