The scenario seems like something out of a movie: someone in the operating room is completely awake, even conversing with the surgeons while they perform a kidney transplant on him. Well, this scenario is already a reality in some cutting-edge hospitals: and over time it will radically transform the transplant experience for patients.
The pioneer of awake kidney transplantation
Doctor Satish Nadig, director of the Comprehensive Transplant Center at Northwestern Medicine in Chicago, is leading this real revolution. His program is called AWAKE Kidney (here you can find out more), and uses fast-track surgery without general anesthesia for kidney transplants, an approach that is redefining the standard of care.
It was Mr Harry Stackhouse the first patient to undergo this innovative procedure. “I saw it all,” says the 74-year-old, describing how he conversed with doctors, examined the organ donated for the kidney transplant and watched the surgical team close it. Surprisingly, he didn't feel any pain during the entire process.
For him the experience was transformative. Not only was he able to witness his own transplant, but he also enjoyed a remarkably rapid recovery. His quick recovery allowed him to quickly return to daily activities, such as mowing the lawn and preparing his boat for a fishing trip.
Other cases followed: nice one (you can see it in this photo). John Nicholas (left) with his kidney donor, Pat Wise, his close friend since childhood.
The surgical technique adopted
Dr. Nadig uses spinal anesthesia for kidney transplants, similar to that used for cesarean deliveries. This technique, combined with targeted anesthetic blocks in the abdomen and spine, avoids the use of opioid narcotics and encourages early postoperative nutrition.
The technique shows extraordinarily promising results, but of course experts stress that further experience will be needed to determine how widespread it can be, especially to patients with underlying conditions such as obesity or heart disease.
Benefits of Awake Kidney Transplant
This new method offers numerous advantages over the traditional approach:
- Avoid the risks of general anesthesia, such as vocal cord damage and delays in bowel function.
- Reduces “brain fog”, post-operative brain fog, which is particularly problematic in older patients.
- Allows quicker discharge: Stackhouse
he was discharged after just 36 hours, compared to the average of 5-7 days for sedated patients.
Conclusion
Awake kidney transplant represents a significant advance in transplant surgery. Potentially offering faster recovery, fewer complications and a more positive patient experience, this technique could mark the beginning of a new era in the field of organ transplants.
However, as with any medical innovation, careful monitoring and further studies will be necessary to fully evaluate the long-term benefits and large-scale applicability of this technique, including on other types of transplants. Meanwhile, patients like Stackhouse are already experiencing the benefits of this revolutionary approach, paving the way for a future where a kidney transplant is an opportunity to have a chat in the operating room. A daydream, literally.
