"I saw it all": At 74, Harry Stackhouse watched as doctors transplanted a new kidney into his body. A painless experience that allowed him to talk with the surgeons, see his new organ, and watch the medical team stitch it back together.
Mr. Stackhouse underwent surgery on July 15 in the Chicago area at the American institution Northwestern Medicine, which is seeking to generalize these transplants performed without general anesthesia.
Completed in just over an hour, the operation was the second of its kind for Satish Nadig, director of the Chicago-based Comprehensive Transplant Center. He has since performed a third.
"We are now at an inflection point for transplantation," Nadig told AFP.
Although medical literature has reported for several decades and in different countries a few kidney transplants performed on awake patients using the same technique as a caesarean section, this practice has never been fully adopted.
"It's time to challenge the paradigms we've historically held onto," Nadig said, as this year marks the 70th anniversary of the first successful living kidney transplant.
General anesthesia typically requires intubation, which can damage vocal cords, disrupt bowel movements, and create persistent "brain fog," especially in older patients. It can also pose a risk of more serious but rare cardiac or pulmonary complications for some people.
– “It was incredible” –
A father of six, Mr. Stackhouse first experienced flu-like symptoms in late 2019. They worsened to the point where he could barely walk.
A few months later, this painter and decorator ended up in the emergency room where he learned that in addition to having contracted Covid-19, one of his kidneys was failing and the other was only functioning at 2%.
He is forced to undergo dialysis sessions three times a week, but his condition worsens and his daughter Trewaunda urges him to consider a transplant and offers to test her compatibility to see if she can become his donor.
Initially reluctant, Mr. Stackhouse eventually agreed.
His meeting with Professor Nadig and the discovery of the program for surgery without general anesthesia, the "AWAKE Kidney Program", made his decision.
"Believe it or not, I didn't feel a thing—it was incredible," Stackhouse told AFP. He spoke with the medical team during the operation and when they offered to see the kidney that was to be transplanted, he accepted without hesitation. "I didn't think a kidney was that big!"
Given his age, Mr Stackhouse was able to go home 36 hours after the operation. Professor Nadig's first patient, operated on in May, was discharged after 24 hours, well below the average of five to seven days for an operation under general anaesthetic.
– “A gift” –
Satish Nadig attributes this success to scientific advances such as the ability to target anesthesia to the abdomen or spine.
Avoiding opioids and encouraging patients to eat quickly after surgery had already reduced the average length of stay for patients.
After the operation, Mr. Stackhouse made a very good recovery: he is walking, mowing the lawn and preparing his boat for a future fishing trip.
He recovered even faster than his 45-year-old daughter, Trewaunda, who underwent general anesthesia.
"It's just a gift you can give to someone (...) you give them back their quality of life," the teacher explained to AFP.
Christopher Sonnenday, director of the University of Michigan Medical Center's Transplant Center, praised the Northwestern Medicine team for "significant innovation."
"Reducing the use of general anesthesia has proven effective in speeding recovery (of patients) in all surgical disciplines," he adds.
But practice will determine how widespread the procedure can be in kidney transplant surgery, he said, and how it can be offered to patients who are obese or have heart disease, who are at greater risk of complications from general anesthesia.
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