Doctors have successfully performed a kidney transplant on a patient who remained awake throughout the procedure.

The surgery was performed at Northwestern Medicine Hospital on John Nicholas, 28, of Chicago, who experienced no pain and was discharged less than 24 hours after the surgery.

In place of general anesthesia, doctors used a spinal anesthesia shot, making the transplant accessible to high-risk patients and reducing hospital stays.

“This is our first case of an awake kidney transplant in which the patient went home the next day, making this essentially an outpatient procedure,” said Dr. Satish Nadig, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center.

“It was incredible to show the patient his new kidney before it was transplanted,” he said.

On May 24, Dr. Nadig, Dr. Vinayak Rohan and Dr. Vicente Garcia Tomas performed the two-hour surgery using a type of anesthesia similar to that used during a caesarean section.

“The anesthesia for this transplant was easier than many C-sections. We used a spinal anesthesia shot with mild sedation, which helped John stay conscious and made his experience better,” said Dr. Garcia Tomas.

Despite Nicholas having no risk or fear of general anesthesia, he was an ideal candidate due to his age and low risk factors.

“It was a really cool experience to know what was happening in real time and be aware of the scale of what they were doing,” Nichols said.

“At one point during the surgery I remember asking, ‘Should I expect the spinal anesthesia to wear off?’ They were already doing a lot of the work and I was completely unaware of that fact. Honestly, there was no sensation of any kind. I was given some sedation for my comfort, but I was still aware of what they were doing. Especially when they called out my name and told me about certain milestones they had achieved,” the patient added.

Usually kidney transplant patients stay in the hospital for 2-3 days, but Nicholas left the hospital just a day after his successful surgery.

Nicholas has had kidney problems since the age of 16, after being diagnosed with Crohn’s disease. His kidney function was declining, and by 2022 a kidney transplant was necessary.

Finding a donor was challenging. Her mother was unable to donate due to a breast cancer diagnosis. Luckily, her best friend, Pat Wise, stepped in and found a match.

Looking to the future, Northwestern Medicine aims to establish the AWAKE program (Accelerated Surgery Without General Anesthesia in Kidney Transplantation) for specific patients who may benefit from this approach.

“This opens a new door in transplantation,” Dr. Nadig said.