When John Nicolas went under the knife for his kidney transplant last month, the Chicago native was fully awake and aware. The 28-year-old participated in a major first for the Illinois hospital.

“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, director of the Northwestern Medicine Comprehensive Transplant Center, said in a news release.

Rather than using general anesthesia, the transplant surgeon and his team used a specialized spinal shot that allowed Nicolas to painlessly and safely remain cognizant for his procedure. It’s a new operation designed to aid patients who face serious health risks when placed under general anesthesia.

A success, Nicolas was discharged less than 24 hours after the operation.

“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. “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. 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.”

Now, Northwestern Medicine is establishing a new program, AWAKE, which stands for accelerated surgery without general anesthesia in kidney transplantation, for patients just like Nicholas. Through the program, the hospital hopes to offer this new procedure to anyone with significant anesthesia phobias, health risks or unique circumstances that make it impractical.

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

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