June 2024

ORGAN TRANSPLANT

AWAKE KIDNEY TRANSPLANTATION: A REVOLUTION IN RENAL CARE

Featuring: Satish Nadig, MD, PhD, Vinayak S. Rohan, MD, and Vicente A Garcia Tomas, MD

​Surgeons at Northwestern Medicine performed a living donor kidney transplant on a 28-year-old man with stage 5 chronic kidney disease. The patient remained awake during the surgery without general anesthesia and was discharged home less than 24 hours post-op. He reported feeling no pain during surgery. 
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This was the first awake kidney transplant performed at Northwestern Medicine. Since then, the team has performed 14 more, and that number continues to climb.

Benefits of Awake Kidney Transplantation

For this surgery, the patient was given a spinal anesthesia shot instead of general anesthesia, an approach that offers several advantages:
  • Increased access to transplantation for patients at high risk for general anesthesia
  • Shortened length of hospital stay to one day vs. the two to five days with general anesthesia
  • Reduced risks associated with general anesthesia
  • Improved patient experience, allowing patients to recover more comfortably at home
  • Beneficial for patients with phobias related to general anesthesia

The Spinal Anesthesia Shot
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Satish N. Nadig, MD, PhD, is a transplant surgeon and director of Northwestern Medicine Comprehensive Transplant Center. He performed the surgery, which took less than two hours, with Transplant Surgeon Vinayak S. Rohan, MD, and Vicente A. Garcia Tomas, MD, anesthesiologist and chief of Regional Anesthesiology and Acute Pain Medicine at Northwestern Medicine.

“Doing anesthesia for the awake kidney transplant was easier than a C-section,” says Dr. Garcia Tomas. “For this case, we placed a spinal anesthesia shot in the operating room with a little bit of sedation for comfort.”

The Future of Awake Transplantation

Since the first awake kidney transplant, Northwestern Medicine has established an AWAKE Program (Accelerated Surgery Without General Anesthesia in Kidney Transplantation) for more patients who could benefit from this type of procedure. This will provide new avenues to transplantation for people who were otherwise not candidates due to risks associated with general anesthesia. It will also greatly decrease opioid use and length of stay.​​
Satish N. Nadig, MD, PhD, is director of the Comprehensive Transplant Center, chief of Organ Transplantation in the Department of Surgery, and the Edward G. Elcock Professor of Surgical Research at Northwestern Medicine.
Vinayak S. Rohan, MD, is a transplant surgeon and associate professor, of organ transplantation in the Department of Surgery at Northwestern Medicine.
Vicente A Garcia Tomas, MD, is chief of Acute Pain/Regional in the Department of Anesthesiology and assistant professor, Anesthesiology (Acute Pain/Regional) at Northwestern Medicine.

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