Northwestern Medicine's AWAKE (Accelerated Surgery Without General Anesthesia in Kidney Transplantation) program is quietly rewriting the playbook on organ transplantation. Launched after the institution's first-ever awake kidney transplant in 2024, the program uses a single spinal or epidural anesthesia injection in place of general anesthesia — keeping patients conscious, breathing, and even talking throughout the procedure.

The benefits go beyond the operating room. Patients in the program have shown earlier return of bowel function, faster mobility, and shorter hospital stays compared to those receiving general anesthesia. Perhaps most significantly, the approach opens the door to patients who were previously considered too high-risk for transplant — including those with myasthenia gravis, cardiopulmonary disease, or allergies to general anesthetic drugs.

Key Takeaways:

• 25 awake kidney transplants have been completed to date at Northwestern Medicine
• 25% of AWAKE program patients were discharged within 1 day of surgery
• The average U.S. kidney transplant hospital stay is 5–7 days; Northwestern had already reduced it to ~2 days
• Eligible candidates include both healthy patients seeking faster recovery and high-risk patients who cannot tolerate general anesthesia
• Surgeons envision kidney transplantation eventually becoming a fully outpatient procedure

Why it matters: By eliminating general anesthesia, the AWAKE program not only speeds up recovery but also expands access to life-saving transplants for patients who previously had no options — a meaningful step toward making kidney transplantation safer and more inclusive.