Man is wide awake during trailblazing kidney transplant procedure at Northwestern Memorial

A Chicago man was wide awake as he witnessed Northwestern Medicine surgeons place his childhood best friend's kidney inside of him during a cutting-edge kidney transplant procedure.

John Nicholas, 28, underwent the surgery on May 24 and "felt no pain" as doctors decided against general anesthesia, and instead opted for a spinal anesthesia shot, the Chicago-based healthcare system said Monday in a news release.

Nicholas was discharged from the hospital and at home less than 24 hours after the procedure, which took under two hours to complete, according to the healthcare system. The normal hospitalization for kidney transplant patients at Northwestern Memorial Hospital is typically two or three days, Northwestern Medicine said.

"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," Dr. Satish Nadig, one of the transplant surgeons at Northwestern Medicine who performed the procedure, said in the release. "Our hope is that awake kidney transplantation can decrease some of the risks of general anesthesia while also shortening a patient’s hospital stay."

Kidney transplants: Procedures usually last 10 to 15 years. Hers made it 50, but now it's wearing out.

Patient says kidney transplant procedure was 'pretty cool experience'

Dr. Vicente Garcia Tomas, an anesthesiologist who assisted during the procedure, said, "Doing anesthesia for the awake kidney transplant was easier than many C-sections."

"For John’s case, we placed a spinal anesthesia shot in the operating room with a little bit of sedation for comfort," Tomas said in the release. "It was incredibly simple and uneventful, but allowed John to be awake for the procedure, improving the patient experience."

Nadig called the procedure an "incredible experience" because doctors were able to show Nicholas what his new kidney looked like before placing it inside his body.

“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,” Nicholas said in the release. “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."

John Nicholas receives a kidney from one of his 'ride or die' friends

Nicholas needed the transplant after his kidney function declined in 2022 due to his ongoing battle with Crohn's disease, which began when he was 16 years old, according to the healthcare system. He was able to avoid dialysis and manage his kidney inflammation by using medication for years until it became clear he would eventually need a transplant, Northwestern Medicine said.

Finding a donor was challenging as his mother initially was supposed to give him her kidney, but she was unable to donate following a breast cancer diagnosis, according to the release. Nicholas would then reach out to his childhood friends who he had known since they attended elementary school in Zionsville, Indiana, and 29-year-old Pat Wise was one of them, the healthcare system said.

"I was in my kitchen cooking dinner and John sent a message that read, ‘My doctor says it’s time for me to start looking for kidney donors.’ I stared at my phone and without hesitating, filled out the form that night,” Wise said about receiving the text from Nicholas, per the release. “John is a good friend. He needed a kidney, and I had an extra one. I had to at least explore the potential of being his donor.”

Once Wise was declared a match, he traveled from Alexandria, Virginia to Chicago where surgeons removed one of his kidneys and transplanted it into Nicholas, according to Northwestern Medicine.

“I have been blessed with a friend group that has stayed together from such a young age,” Nicholas said in the release. “We always called ourselves ‘ride or die’ friends, and this example shows that we have each other’s backs. It meant the world to me. It’s truly been life-changing.”

Procedure 'opens up a whole new door' for future kidney transplants

Nicholas, who had to limit salt intake before the procedure, is now eager to enjoy a couple of slices of pizza and have more energy to ride his bicycle around Chicago, according to the release.

“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 because of him, he’s now helping to move the field of transplantation forward,” Dr. Vinayak Rohan, a surgeon who helped perform the procedure, said in the release.

Northwestern Medicine is now looking to establish the AWAKE Program (Accelerated Surgery Without General Anesthesia in Kidney Transplantation) for patients who want to undergo the operation but can not have general anesthesia because they're at high risk for complications or other reasons.

“It really opens up a whole new door and is another tool in our toolbelt for the field of transplantation,” Nadig said in the release.

This article originally appeared on USA TODAY: Northwestern Medicine kidney transplant happens as patient is awake