Modern Frankenstein, or Fantastical Miracle? – The Dish on the First Head Transplant

You’ve heard of people getting heart, lung, liver, kidney, and even face transplants with the recent successful Mayo clinic operation. But have you heard of getting a head transplant – that is, severing the head and replacing the body with a new body? That is exactly what Dr. Sergio Canavero, affectionately termed by the media as “Dr. Frankenstein” wants to accomplish by the end of 2017 for his first volunteer patient, Valery Spirinodov, a computer scientist from Russia. Quite frankly, it sounds like something out of science fiction! Nevertheless, Dr. Canavero is extremely confident in the project, citing a 90% chance of success – as he argues, we have the necessary technologies to be able to carry this operation out with minimal danger.

Mr. Spirinodov suffers from the rare Werndig-Hoffman disease, which is essentially an aberrant form of spinal muscular atrophy. Thus, he is confined to a wheelchair as his body gradually deteriorates and problems with moving, breathing and swallowing accumulate. Most individuals with such a disease do not survive past the first few years of life, but Mr. Spirinodov is one of the exclusive 10% who do survive into adulthood. Yet even still, he has only a few years to live before his body is completely ravaged by the disease. With full knowledge of this, Mr. Spirinodov decided to volunteer for the pilot head transplant for the chance to procure a new body and possibly a new life.

Previously there has been an attempt to perform a head transplant on a monkey in the 1970s, carried out by Dr. Robert White of Case Western Reserve University School of Medicine. Unfortunately, due to the lack of technology to properly reattach the spinal cord, major arteries, and veins, the monkey died eight days after the procedure. But more recently, there has been more head transplants performed on mice in China that have been successful. Furthermore, a team of researchers led by Dr. Xiaoping Ren at Harbin Medical University in China have successfully executed a head transplant on a monkey, connecting the blood supply but not the spinal cord and showed that the procedure did not lead to brain injury as the head was cooled to 15°C. The monkey however, was kept alive for only 20 hours after the surgery for ethical reasons.

In this specific operation, Dr. Canavero has released a detailed outline of his plan to the public. The donor body will come from a brain dead, but physically healthy transplant donor. First the head and body of the patient will be frozen to prevent brain cell degeneration, and the surgeons will begin by carefully cutting through the soft tissue of the neck. The major arteries and veins will be hooked up to machines that will supply blood flow and then the spinal cord will be severed quickly by a diamond knife for a clean cut.

The reattachment process is highlighted by this special glue Dr. Canavero coins as his “magic ingredient” – a chemical compound called polyethylene glycol whose glue-like properties will help fuse the spinal cord of the donor’s headless body and the patient’s head together. Then, the surgeons will quickly reattach all the nerves and blood vessels to the donor body. As a finishing step, the patient will then be placed under drug-induced coma for four weeks to allow for the proper healing and fusion of the spinal cord, blood vessels and flesh. Powerful immunosuppressants will be used to prevent the rejection of the head by the donor body and vice versa. It is predicted that when the patient wakes, they will be able to move, feel their face, and even speak.

Dr. Canavero predicts that this whole procedure will take approximately 36 hours and 150 trained medical professionals to carry out. In preparation for the operation, his team will practice on brain dead, living donors by cutting their spinal cords and reattaching them, and then monitor their recovery and neuro-physiological condition through electrical impulses.  

Using the same adhesive – polyethylene glycol – they also performed the operation on dogs, removing the heads completely then reattaching the spinal cord with the chemical; from this experiment, the dog made a recovery within two weeks. But as they say, everything has a price tag. This procedure just has a slightly bigger one – an estimated 14 million euro. Currently, Mr. Spirinodov and Dr. Canavero are working on raising funds for the grand medical procedure.

Of course, there is no shortage of dissent in regard to this procedure. Some are quick to laud this as a cure-all solution to those with paraplegic and muscle deteriorating conditions. Like Dr. Canavero, they believe that this transplant will succeed where gene therapy and stem cell therapy has failed to deliver in a timely fashion, that this could mark a new era in medicine.

Citing the recent successes of the facial transplants, they are optimistic that if the face could be transplanted, the head could be transplanted as well. In the case that the head transplant operation does succeed and is further perfected to minimize cost, then perhaps we may have stumbled upon a gateway to a world of spinal cord trauma injury solutions.

However, others are more skeptical. They critique the procedure outlined by Dr. Canavero as “oversimplified” and “overly fantastical”, stating that there are too many scenarios where the operation could go wrong.

Robert Truog, director of the Center of Bioethics suggests that this procedure may have serious consequences on personal identity. Another argues that the combination of a head with a separate body could result in higher levels of insanity. Arthur Caplan, director of medical ethics at the Lagone Medical Centre of New York University provided an explanation for this, stating that the different pathways and chemistry on the donor body will overwhelm the patient’s head, thus producing chemically-induced insanity.

With such a controversial proposal as this, there are also huge ethical issues to be resolved. One concern regards the allocation of resources. Consider this: for the head plant, you will need the whole donor’s body, one that is full of transplantable organs, to ameliorate the life of one person. What if these organs were distributed to 10 different patients needing different transplants? Does the life of that one individual needing a head transplant supersede the lives of these 10 other individuals? As such, how do we allocate the resources from the donor’s body? There are no ways to determine the right answer to these questions.

Ultimately, will this procedure end up in tragedy as Mary Shelley’s iconic Frankenstein? Or will it be the next fantastical miracle? Only time will tell. However, technological development in medicine is clearly proceeding at an exponential rate. What was previously thought to be impossible will be accomplished in the span of decades. The question is: Are we ready for it?

 

References

http://www.dailymail.co.uk/health/article-3721986/Patient-set-undergo-world-s-human-head-transplant-says-Dr-Frankenstein-reveal-details-operation-month.html

http://www.bbc.co.uk/newsbeat/article/37420905/the-surgeon-who-wants-to-perform-a-head-transplant-by-2017

https://www.extremetech.com/extreme/236006-surgeon-plans-first-human-head-transplant-in-2017

http://www.independent.co.uk/news/science/chinese-surgeon-who-has-performed-1000-head-transplants-on-mice-wants-to-create-the-first-head-10304115.html

http://www.independent.co.uk/news/science/man-undergoing-head-transplant-could-experience-something-a-lot-worse-than-death-says-neurological-10164423.html

https://www.newscientist.com/article/2073923-head-transplant-carried-out-on-monkey-claims-maverick-surgeon/

Photo Links

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http://www.medicalnewstoday.com/content/images/articles/301/301790/brain-and-spinal-cord.jpg

 

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