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.
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Stat of the week
More than 59% of women may have high blood pressure by 2050, according to a new report from the American Heart Association.
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A new report by the American Heart Association (AHA) included some troubling predictions for the future of women’s health.
The forecast, published in the journal Circulation on Wednesday, projected increases in various comorbidities in American females by 2050.
More than 59% of women were predicted to have high blood pressure, up from less than 49% currently.
The review also projected that more than 25% of women will have diabetes, compared to about 15% today, and more than 61% will have obesity, compared to 44% currently.
As a result of these risk factors, the prevalence of cardiovascular disease and stroke is expected to rise to 14.4% from 10.7%.
The prevalence of cardiovascular disease and stroke in women is expected to rise to 14.4% from 10.7% by 2050. (iStock)
Not all trends were negative, as unhealthy cholesterol prevalence is expected to drop to about 22% from more than 42% today, the report stated.
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Dr. Elizabeth Klodas, a cardiologist and founder of Step One Foods in Minnesota, commented on these “jarring findings.”
“The fact that on our current trajectory, cardiometabolic disease is projected to explode in women within one generation should be a huge wake-up call,” she told Fox News Digital.
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“Hypertension, diabetes, obesity — these are all major risk factors for heart disease, and we are already seeing what those risks are driving. Heart disease is the No. 1 killer of women, eclipsing all other causes of death, including breast cancer.”
Cardiovascular disease is the leading cause of death for women in the U.S. and around the world. (iStock)
Klodas warned that heart disease starts early, progresses “stealthily,” and can present “out of the blue in devastating ways.”
The AHA published another study on Thursday revealing one million hospitalizations, showing that heart attack deaths are climbing among adults below the age of 55.
The more alarming finding, according to Klodas, is that young women were found more likely to die after their first heart attack than men of the same age.
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“This is all especially tragic since heart disease is almost entirely preventable,” she said. “The earlier you start, the better.”
Children can show early evidence of plaque deposition in their arteries, which can be reversed through lifestyle changes if “undertaken early enough and aggressively enough,” according to the expert.
Moving more is one part of protecting a healthy heart, according to experts. (iStock)
Klodas suggested that rising heart conditions are associated with traditional risk factors, like smoking, high blood pressure, high cholesterol, diabetes, obesity and a sedentary lifestyle.
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Doctors are also seeing higher rates of preeclampsia, or high blood pressure during pregnancy, as well as gestational diabetes. Klodas noted that these are sex-specific risk factors that don’t typically contribute to complications until after menopause.
The best way to protect a healthy heart is to “do the basics,” Klodas recommended, including the following lifestyle habits.
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Klodas especially emphasized making improvements to diet, as the food people eat affects “every single risk factor that the AHA’s report highlights.”
“High blood pressure, high blood sugar, high cholesterol, excess weight – these are all conditions that are driven in part or in whole by food,” she said. “We eat multiple times every single day, which means what we eat has profound cumulative effects over time.”
“Even a small improvement in dietary intake, when maintained, can have a massive positive impact on health,” a doctor said. (iStock)
“Even a small improvement in dietary intake, when maintained, can have a massive positive impact on health.”
The doctor also recommends changing out a few snacks per day for healthier choices, which has been proven to “yield medication-level cholesterol reductions” in a month.
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“Keep up that small change and, over the course of a year, you could also lose 20 pounds and reduce your sodium intake enough to avoid blood pressure-lowering medications,” Klodas added.
“Women should not view the AHA report as inevitable. We have power over our health destinies. We just need to use it.”
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