Head transplant dog (640 x480)

Italian surgeon, Sergio Canavero of the Turin Advanced Neuromodulation Group (TANG), says he is going to announce plans to conduct the first-ever human head (or is it actually a body) transplant during his keynote address at the American Academy of Neurologic and Orthopedic Surgeons June 2015 [Update: he did give his keynote and evidently there was some controversy as indicated in this letter from the Chairman of the Board of Directors of the Academy to members.]. He says it could happen within the next two years.

He has already published the method he is planning to use in an editorial in the Journal of Surgical Neurology International (it’s real, I checked). The procedure, called cephalosomatic anastomosis or CSA, consists of fusing the spinal cords of the head and the donor body and then flushing it with polyethylene glycol to encourage the fat in the cell membranes to mesh. The blood vessels and muscles are sutured together and the patient is placed into a coma for about a month. During this time, the spinal cord is subject to electrical stimulation to enhance new nerve connections. He believes that immune rejection of the head, a problem in prior efforts to do head transplants, can now be controlled with drugs.

He thinks the procedure could be life-saving in people with metastatic cancer (presumably without brain mets) or muscle wasting disorders, such as muscular dystrophy. It has also been suggested that severely paralyzed people (e.g., quadriplegics) with widespread organ failure might be candidates for a head transplant instead of multiple individual organ transplants. And, he says several people have already volunteered for the procedure.

 

A brief history of head transplants

Two heaaded dog
Dr. Demikhov’s two-headed dogs survived up to 29 days. (Photo from news.com.au, Source: Corbis)

Prior efforts to transplant heads provide some hints about why such an operation could be successful. The first surgery that resulted in a head that functions, albeit briefly, was done by Soviet transplantation expert, Vladimir Demikhov. In 1954, he transplanted a puppy’s head onto the back of a full grown German shepherd. During the time, he observed the puppy post-op, who bit the finger of one of his staff and later bit the ear of the German shepherd. I am sure if he could have, he would have bit off both of Demikhov’s hands so that he would not be able to do this to another puppy ever again. The animal(s?) died after the body rejected the foreign head.

In 1970, a team led by Case Western Reserve neurosurgeon, Dr. Robert White, transplanted a rhesus monkey head onto the decapitated body of another rhesus. Although paralyzed because the surgeons weren’t able to fuse the spinal cord to the head, the animal was able to smell, taste, hear, and see. Dr. White’s colleague, Dr. Jerry Silver recollected for CBSNews.com,

“I remember that the head would wake up, the facial expressions looked like terrible pain and confusion and anxiety in the animal. The head will stay alive, but not very long. When doctors attempted to feed the re-connected head, the food fell to the floor. It was just awful. I don’t think it should ever be done again.”

This animal survived nine days, long enough to try to bite some of the staff several times. (Seems to be a pattern here.)

In 2002, Japanese researchers transplanted rat heads onto the bodies of rats that kept their original heads, thus becoming two-headed. I did not find any reports of the rats biting the hands that created them.

So, although these operations have not yielded any long-term survivors, the fact that the heads were able to function before they were rejected suggests that it might just be possible that a human head transplant could be viable.

 

Just because we can, should we?

Needless to say, ethical questions abound. The recipient must be decapitated to “harvest” the head; similarly, the body donor must be decapitated presumably after being declared brain dead. Even Dr. Canavero worries that “without sufficient regulation, the procedure may one day lead to wealthy, aging individuals securing the healthy bodies of young individuals on the black market with ‘unscrupulous’ surgeons carrying out the head transplantation.”

I think it is fitting to close with a quote from Dr. Canavero from a recent article in Wired Magazine:

“There are all these people who tell you: ‘Who is this guy who can do this in two years?’ When you go public with something like this, you have to have two balls like this. [Use your imagination] There are people who are not so strong-balled and will just get crushed by the critics. But I love the critics. This is a feat of theoretical neuroscience and the evidence is there and it’s going to work.”  

So there!

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