First human head transplant could take place by the end of 2017

The first human head transplant (or should it be body transplant?) operation could take place before the end of 2017. Italian neurosurgeon Sergio Canavero has announced the procedure (head anastomosis venture – acronymed by Canavero as ‘HEAVEN’) might be feasible, with better technology and more precise methods to keep neural tissue perfused having become available, by December of 2017, which is when he has proposed to perform the ground-breaking, first-of-a-kind operation, which would be done in either the United States or China.

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A head transplant, a surgical operation involving the grafting of one subject’s head onto the body of another, has been attempted before, although thus far exclusively on animal subjects. The pioneer of the procedure was Dr. Vladimir Demikhov, Soviet scientist who performed several organ transplantations, such as liver, lung and heart replacements, in various animals and also experimented with dog head transplantation in the former Soviet Union and GDR in the late 1950s. His dog subjects typically died shortly after the operation from complications related to immune response. Nonetheless, Demikhov’s work was profoundly influential for the future pioneers of organ transplants, as he established many different forms of transplantation, including the first use of immuno-suppressants. It is not a coincidence that Christiaan Barnard, a South African cardiac surgeon who performed the world’s first successful heart transplant operation from one person to another in 1967, visited Demikhov’s laboratory twice in 1960 and 1963, and considered the Russian his teacher.

Once only a staple of science fiction (such as depicted here in the television series Fringe), the human head transplant can become reality by the end of 2017.

After a decade-long lull, a group of scientists from Case Western Reserve University School of Medicine in Cleveland, Ohio, under direction of doctor Robert J. White, a neurosurgeon inspired by the Demikhov’s work, performed a highly controversial operation of transplanting the head of one monkey onto the body of another. The procedure, carried out in March 1970, was a success to some extent, with the animal being able to smell, taste, hear and see the world around it. The operation involved cauterising arteries and veins carefully while the head was severed to prevent hypovolaemia. Because the nerves were left completely intact, connecting the brain to a blood supply kept it chemically alive. The animal survived for some time after the operation, even at times attempting to bite some of the staff. In 2001, Dr. White successfully repeated the procedure on another monkey.

Whether human head transplant will ever be justified depends not only on the advances in medical science but also the moral and social justification of such undertaking - Robert J.White

White later wrote about the implications of his work: “...What has been accomplished in the animal model – prolonged hypothermic preservation and cephalic transplantation – is fully accomplishable in the human sphere. Whether such dramatic procedures will ever be justified in the human area must wait not only upon the continued advance of medical science but more appropriately the moral and social justification of such procedural undertakings.”

More recently, Prof. Xiaoping Ren, a Chinese orthopaedic surgeon, known for being part of the team of surgeons that achieved the first hand transplant, also stated that such a surgery would be possible. Prof. Ren from Harbin Medical University in China, claims to have recently participated in a successful head transplant operation carried out on a monkey. Researchers said there was no neurological damage to the subject and that it survived for 20 hours before being euthanised. Significantly though, the team did not attempt to connect the spinal cord, in effect leaving out the most problematic part of the procedure. Prof. Ren has also stated to have practiced the procedure on human cadavers in order to perfect the technique.

Sergio Canavero, an Italian neurosurgeon who is in frequent contact with Prof. Ren’s team, outlined the plan to perform the first human head transplant earlier this year in Surgical Neurology International, proposing that such an operation could be undertaken by the end of 2017 and detailing a 36-hour operation that would require assistance of no less than 150 doctors, nurses and other supporting staff. Canavero describes the procedure as follows: after cooling down the patient’s head to about 12-15˚C, the tissue around the neck is cut, with the major blood vessels linked with tiny tubes. Then, the spinal cords of both the donor and the recipient will be cleanly severed with an extremely sharp blade. The two ends will be connected and fused using a chemical called polyethylene glycol, the substance that has been shown to promote the growth of spinal cord nerves in animals, which should stimulate the connection of fat tissues. Finally, muscles and blood vessels will be sutured together. Following the operation, the patient would be kept in an induced coma for about a month to prevent any undesired movement, while their spine would be stimulated with electrodes to strengthen nerve connections and speed up the healing process.

Italian neurosurgeon Sergio Canavero thinks that the medical science advanced sufficiently to enable the first human head transplant operation – but his critics ask if he considered the procedural risks as well as moral and social implications of such an undertaking.

Despite the scale of the problem and complexity of the operation, Canavero is confident that the procedure will work, asserting that in the last few years this operation has been successfully performed on dozens of mice who were functionally alive, as well as on dogs and monkeys who have subsequently survived for a few days. His optimism even goes so far as to predict that the patient would be able to walk within a year of the operation (in spite of the above mentioned brief lifespan of all previous animal test subjects).

Neurosurgeon Sergio Canavero thinks that he is ready to carry out the world’s first human-to-human head transplant operation – but many of his critics disagree.

However, many of Canavero’s critics say a successful head transplant is still very far from becoming a reality for a multitude of reasons – the main one being the fusion of the spinal cords, something that has never been successfully achieved before. Transplant rejection, a condition when donor’s transplanted tissue is rejected by the recipient’s immune system, is also a major concern, although the danger of this happening can be somewhat lessened by use of immunosuppressant drugs. Adding to the huge practical problems, Canavero and his team face also the ethical objections to carrying out such a controversial and untested procedure on a human being.

Amongst Canavero’s more prominent critics is Dr. Hunt Batjer, Chair of Department of Neurological Surgery at UT Southwestern and an internationally recognised expert in cerebrovascular surgery specialising in ischemic and haemorrhagic stroke states, as well as an accepted authority on brain injury. Dr. Batjer was quoted as saying: “I would not allow anyone to do it to me as there are a lot of things worse than death” – in reference to the possible disastrous outcome of the surgical procedure. In an interview with CNN, Batjer goes on explaining that even if the spinal cords can be connected, the body might neither be able to handle all the new chemical connections made, nor the amount of toxicity coming from the large number of anti-rejection medications the patient will be receiving after the operation.

Notwithstanding the wide-ranging criticism and objections, Dr. Canavero is determined to press on with his plan. All the more now, when he has already found a possible human candidate for the procedure in Valery Spiridonov, 30-year-old Russian with Werdnig-Hoffmann Disease and rapidly declining health. Mr Spiridonov, who is well aware of the great risks associated with the operation, says that “he doesn’t really have many choices” and that if he “don’t try this, his fate will be very sad” – considering that his condition is getting progressively worse and there is no alternative treatment available.

Providing everything goes according to the plan, Sergio Canavero is planning to carry out the world’s first head transplant in December 2017.