Health
Chicago man receives kidney transplant while fully awake, goes home very next day
Kidney transplants are not uncommon — the kidney is actually the most frequently transplanted organ in the U.S. — but a Chicago man recently received his in a highly unusual way.
John Nicholas, 28, was awake during the entire procedure, which was performed on May 24 at Northwestern Medicine Hospital. He was discharged the very next day.
Doctors administered a spinal anesthesia shot — similar to what is used for a Cesarean section — instead of general anesthesia, according to a press release from the hospital.
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“This is the first case at Northwestern Medicine where a patient was awake during an entire kidney transplant procedure and went home the next day, basically making this an outpatient procedure,” said Satish Nadig, M.D., PhD, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center, in the release.
“Inside the operating room, it was an incredible experience being able to show a patient what their new kidney looked like before placing it inside the body,” he added.
John Nicholas, the patient, is pictured with his surgeons in the operating room after completion of the kidney transplant. (Northwestern Medicine)
“It was incredibly simple and uneventful.”
This type of “awake transplant” could reduce surgical risks and shorten the length of the patient’s hospitalization, doctors say.
“It was an incredible experience, being able to show a patient what their new kidney looked like before placing it inside the body.”
It could also increase access to care for patients who are considered high-risk or have phobias surrounding general anesthesia.
Ideal candidate
Nicholas’ surgery took about two hours, according to the hospital.
He was considered an ideal patient for awake surgery due to his young age, his otherwise good health and his “eagerness to participate,” per the release.
John Nicholas is pictured awake during his kidney transplant in late May. (Northwestern Medicine)
“It was a pretty cool experience to know what was happening in real time and be aware of the magnitude of what they were doing,” said Nicholas in a statement to Northwestern.
“At one point during surgery, I recall asking, ‘Should I be expecting the spinal anesthesia to kick in?’ They had already been doing a lot of work and I had been completely oblivious to that fact. Truly, no sensation whatsoever.”
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Although Nicholas did receive sedation for comfort, he said he was still aware of what was going on.
“Especially when they called out my name and told me about certain milestones they had reached,” he noted.
Nicholas, center, is pictured after surgery with Dr. Vicente Garcia Tomas, his anesthesiologist, at left, and Dr. Nadig, transplant surgeon, at right. (Northwestern Medicine)
Nicholas walked out of the hospital on May 25, the day after surgery.
With typical kidney transplants, the recipient remains in the hospital for two to three days.
Saved by a friend
Nicholas’ kidney issues began at age 16 when he was diagnosed with Crohn’s disease, the release stated.
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After a few years of managing the condition with medication, his kidney function worsened and he required a transplant.
Nicholas’ mother originally planned to donate her kidney, but a breast cancer diagnosis prevented her from doing so, the hospital relayed.
Nicholas, at left, is pictured with his donor and best friend, Pat Wise, after surgery. (Northwestern Medicine)
It was Nicholas’ best friend from elementary school, 29-year-old Pat Wise in Alexandria, Virginia, who ultimately donated the life-saving kidney.
‘Another tool in our toolbelt’
Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in the surgery but shared his input.
“My opinion is that in most cases, spinal anesthesia presents a reasonable alternative for those at high risk of general anesthesia complications,” Siegel told Fox News Digital.
Nicholas is pictured awake with his care team during his kidney transplant surgery. (Northwestern Medicine)
“Having said that, general anesthesia would be preferred whenever possible for major surgery like this,” said Dr. Siegel, “because control of the airway and breathing is essential, and is much easier if the patient is asleep and on the ventilator.”
The doctors at Northwestern credit the patient for helping to advance the field of transplant medicine.
Nicholas, left, and donor Wise are pictured at a press conference after the surgery. (Northwestern Medicine)
“When John agreed to be the first known patient at Northwestern Medicine to undergo an awake kidney transplant and be discharged home the next day, he knew the benefits outweighed the risks, and … he’s now helping to move the field of transplantation forward,” said Vinayak Rohan, M.D., transplant surgeon at Northwestern Memorial Hospital, in the release.
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“He is an extremely compliant patient who was in tune with his body and willing to push the envelope,” stressing that the patient had faith in the doctors and they, in turn, had faith in him.
Nicholas, center, is pictured with his entire care team. “He’s now helping to move the field of transplantation forward,” a surgeon said about the patient. (Northwestern Medicine)
The hospital now plans to establish the AWAKE Program (Accelerated Surgery Without General Anesthesia in Kidney Transplantation) for patients who want or need to pursue surgery without general anesthesia.
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“It really opens up a whole new door and is another tool in our toolbelt for the field of transplantation,” Nadig added.
Fox News Digital reached out to Northwestern Medical for additional input.
Health
Ancient plague mystery cracked after DNA found in 4,000-year-old animal remains
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Long before the Black Death killed millions across Europe in the Middle Ages, an earlier, more elusive version of the plague spread across much of Eurasia.
For years, scientists were unsure how the ancient disease managed to spread so widely during the Bronze Age, which lasted from roughly 3300 to 1200 B.C., and stick around for nearly 2,000 years, especially since it wasn’t spread by fleas like later plagues. Now, researchers say a surprising clue may help explain it, a domesticated sheep that lived more than 4,000 years ago.
Researchers found DNA from the plague bacterium Yersinia pestis in the tooth of a Bronze Age sheep discovered in what is now southern Russia, according to a study recently published in the journal Cell. It is the first known evidence that the ancient plague infected animals, not just people, and offers a missing clue about how the disease spread.
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“It was alarm bells for my team,” study co-author Taylor Hermes, a University of Arkansas archaeologist who studies ancient livestock and disease spread, said in a statement. “This was the first time we had recovered the genome from Yersinia pestis in a non-human sample.”
A domesticated sheep, likely similar to this one, lived alongside humans during the Bronze Age. (iStock)
And it was a lucky discovery, according to the researchers.
“When we test livestock DNA in ancient samples, we get a complex genetic soup of contamination,” Hermes said. “This is a large barrier … but it also gives us an opportunity to look for pathogens that infected herds and their handlers.”
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The highly technical and time-consuming work requires researchers to separate tiny, damaged fragments of ancient DNA from contamination left by soil, microbes and even modern humans. The DNA they recover from ancient animals is often broken into tiny pieces sometimes just 50 “letters” long, compared to a full human DNA strand, which contains more than 3 billion of those letters.
Animal remains are especially tough to study because they are often poorly preserved compared to human remains that were carefully buried, the researchers noted.
The finding sheds light on how the plague likely spread through close contact between people, livestock and wild animals as Bronze Age societies began keeping larger herds and traveling farther with horses. The Bronze Age saw more widespread use of bronze tools, large-scale animal herding and increased travel, conditions that may have made it easier for diseases to move between animals and humans.
When the plague returned in the Middle Ages during the 1300s, known as the Black Death, it killed an estimated one-third of Europe’s population.
The discovery was made at Arkaim, a fortified Bronze Age settlement in the Southern Ural Mountains of present-day Russia near the Kazakhstan border. (iStock)
“It had to be more than people moving,” Hermes said. “Our plague sheep gave us a breakthrough. We now see it as a dynamic between people, livestock and some still unidentified ‘natural reservoir’ for it.”
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Researchers believe sheep likely picked up the bacteria from another animal, like rodents or migratory birds, that carried it without getting sick and then passed it to humans. They say the findings highlight how many deadly diseases begin in animals and jump to humans, a risk that continues today as people move into new environments and interact more closely with wildlife and livestock.
“It’s important to have a greater respect for the forces of nature,” Hermes said.
The study is based on a single ancient sheep genome, which limits how much scientists can conclude, they noted, and more samples are needed to fully understand the spread.
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The researchers plan to study more ancient human and animal remains from the region to determine how widespread the plague was and which species may have played a role in spreading it.
Researchers (not pictured) found plague-causing Yersinia pestis DNA in the remains of a Bronze Age sheep. (iStock)
They also hope to identify the wild animal that originally carried the bacteria and better understand how human movement and livestock herding helped the disease travel across vast distances, insights that could help them better anticipate how animal-borne diseases continue to emerge.
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The research was led by scientists at the Max Planck Institute for Infection Biology, with senior authors Felix M. Key of the Max Planck Institute for Infection Biology and Christina Warinner of Harvard University and the Max Planck Institute for Geoanthropology.
The research was supported by the Max Planck Society, which has also funded follow-up work in the region.
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Health
Aging-related joint disorder increasingly affects people under 40, study finds
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Cases of gout are rising in younger individuals, according to a global study.
The condition, which is a type of inflammatory arthritis, steadily increased in people aged 15 to 39 between 1990 and 2021, researchers in China announced.
Although rates vary widely between countries, the total number of young people with the condition is expected to continue rising through 2035.
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The study, published in the journal Joint Bone Spine, investigated 2021 data from the Global Burden of Disease (GBD), spanning 204 countries within the 30-year timeframe.
The data measured gout prevalence, incidence and years lived with disability, tracking global trends over time. The results showed a global increase across all three outcomes.
Gout is expected to continue rising in young people through 2035. (iStock)
Prevalence and disability years increased by 66%, and incidence rose by 62%. In 2021, 15- to 39-year-olds accounted for nearly 14% of new gout cases globally, the study found.
Men from 35 to 39 years old and people in high-income regions had the highest burden, but high-income North America topped the list for highest rates.
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Men were also found to have lived more years with gout due to high BMI, while women tended to have the condition as a link to kidney dysfunction, the study noted.
The total number of cases is expected to increase globally due to population growth, but the study projected that rates per population would decrease.
The researchers noted that data quality, especially in low-income settings, could have posed a limitation to the broad GBD data.
What is gout?
Gout is a common form of arthritis involving sudden and severe attacks of pain, swelling, redness and tenderness in the joints, according to Mayo Clinic. It most often occurs in the big toe.
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The condition occurs when urate crystals accumulate in the joint. These form when there are high levels of uric acid in the blood, which the body produces when it breaks down a natural substance called purines.
A gout flare-up can happen at any time, often at night, causing the affected joint to feel hot, swollen, tender and sensitive to the touch.
Urate crystals, described as sharp and needle-like, build up in the joint, causing intense pain and swelling. (iStock)
Purines can also be found in certain foods, like red meat or organ meats like liver and some seafood, including anchovies, sardines, mussels, scallops, trout and tuna, according to the Mayo Clinic. Alcoholic drinks, especially beer, and drinks sweetened with fruit sugar can also lead to higher uric acid levels.
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Uric acid will typically dissolve in the blood and pass through the kidneys into urine, but when the body produces too much or too little uric acid, it can cause a build-up of urate crystals. These are described by the Mayo Clinic as sharp and needle-like, causing pain, inflammation and swelling in the joint or surrounding tissue.
Risk factors for gout include a diet rich in high-purine foods and being overweight, which causes the body to produce more uric acid and the kidneys to have trouble eliminating it.
Experts urge patients to seek medical attention for gout flare-ups. (iStock)
Certain conditions like untreated high blood pressure, diabetes, obesity, metabolic syndrome and heart and kidney diseases can increase the risk of gout, as well as certain medications.
A family history of gout can also increase risk. Men are more likely to develop the condition, as women tend to have lower uric acid levels, although symptoms generally develop after menopause.
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Untreated gout can cause worsening pain and joint damage, experts caution. It may also lead to more severe conditions, such as recurrent gout, advanced gout and kidney stones.
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The Mayo Clinic advises patients to seek immediate medical care if a fever occurs or if a joint becomes hot and inflamed, which is a sign of infection. Certain anti-inflammatory medications can help treat gout flares and complications.
Fox News Digital reached out to the researchers for comment.
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