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Surgeons perform first known kidney transplant with patient awake during procedure
Surgeons at Northwestern Medicine performed a kidney transplant on an awake patient for what is believed to be the first time in the United States.
The patient, 28-year-old John Nicholas of Chicago, felt no pain during the May 24 procedure and was discharged the next day. Typically a patient is hospitalized for 2-3 days following a kidney transplant at Northwestern Memorial Hospital.
“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 a news release, adding he felt “no sensation whatsoever.” “I had been given some sedation for my own comfort, but I was still aware of what they were doing. Especially when they called out my name and told me about certain milestones they had reached.”
Instead of normal general anesthesia, doctors used a single-spinal anesthesia shot, which is similar to what’s used during cesarean sections.
“To our knowledge, this is the first known case in the United States where a patient was awake during an entire kidney transplant procedure. 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,” Dr. Satish Nadig, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center, said in the release.
José M. Osorio
The other exciting element? “The patient was able to be discharged home in less than 24-hours, basically making this an outpatient procedure,” Nadig said. “Our hope is that awake kidney transplantation can decrease some of the risks of general anesthesia while also shortening a patient’s hospital stay.”
It may also offer increased accessibility for those who are at higher risk to undergo general anesthesia.
While this wasn’t the case for Nicholas, he was a candidate thanks to “his age, limited risk factors and eagerness to participate in a medical first,” according to the release.
Nicholas began having kidney issues at 16 after being diagnosed with Crohn’s disease years prior. Though he was able to manage his condition for years with medication, in early 2022 his declining kidney function made it clear he would need a transplant.
With his mom unable to donate following a breast cancer diagnosis, his childhood best friend, 29-year-old Pat Wise, didn’t hesitate to fill out a donor form and was declared a match.
“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,” Nicholas said, who added he’s looking forward to having more energy for bicycle rides and enjoying pizza after having to previously limit his salt intake.
José M. Osorio
Now Northwestern Medicine is looking to establish the AWAKE Program (Accelerated Surgery Without General Anesthesia in Kidney Transplantation) for other patients who want a similar operation.
“It really opens up a whole new door and is another tool in our toolbelt for the field of transplantation,” Nadi said.
As countries around the world experiment with shorter work weeks, Greece has taken a step in the opposite direction — introducing a six-day work week for some businesses that operate on a 24-hour basis.
The six-day work week is allowed according to new legislation that went into effect on July 1, according to CBS News’ partner network BBC News. It is optional for workers, who can work 48 hours instead of the typical 40 hours. Those who opt in can choose between working an additional two hours a day or an extra eight-hour shift, The Guardian reported. Workers will be paid 40% extra for the additional time.
“It is important to note that this measure does not affect in any way the established five-day working week mandated by law. Instead, it serves to address urgent operational demands that cannot be met through the available supply of specialised workers,” a spokesperson for Greece’s Ministry of Labour and Social Security told the BBC.
Greece’s government sees it as a way to boost economic growth and protect workers against “under-declared or undeclared work and ensure fair compensation,” the BBC reported.
Before the Greek parliament endorsed the law, Greek Prime Minister Kyriakos Mitsotakis said “the nucleus of this legislation is worker-friendly, it is deeply growth-oriented. And it brings Greece in line with the rest of Europe,” according to The Guardian.
While workers in Greece may choose to increase their workload, working hours are capped at 48 hours, according to guidelines laid out by the European Union’s Working Time Directive. And as the BBC reports, tourist and food industry businesses are excluded.
The new law comes as other countries are forgoing a five-day work model in favor of shorter work weeks — a movement that gained traction in the wake of the COVID pandemic as workers across the world grew accustomed to more flexible working arrangements.
Trials of a four-day workweek in Iceland were called an “overwhelming success” by researchers in 2021, and many workers there moved to shorter hours, the BBC reported.
In France, the standard work week is 35 hours – per a law adopted in 2000 under the administration of Prime Minister Lionel Jospin – and there’s been a push to whittle it down even further, to 32 hours.
In the U.S., workers have also been clamoring for less time “in office.” More companies across the country are experimenting with a truncated workweek as employees demand flexibility and studies show that working less can make people more productive while boosting a company’s profits.
In March, Sen. Bernie Sanders of Vermont introduced a bill to reduce the work week from 40 hours to 32 without affecting workers’ overall compensation.
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