World’s first human head transplant a success

The world’s first human head transplant has been carried out on a corpse in China in an 18-hour operation that showed it was possible to successfully reconnect the spine, nerves and blood vessels.

At a press conference in Vienna on Friday morning, Italian Professor Sergio Canavero, director of the Turin Advanced Neuromodulation Group, announced that a team at Harbin Medical University had “realised the first human head transplant” and said an operation on a live human will take place “imminently”.

The operation was carried out by a team led by Dr Xiaoping Ren, who last year successfully grafted a head onto the body of a monkey.

Prof Canavero, said: “The first human transplant on human cadavers has been done. A full head swap between brain dead organ donors is the next stage.

“And that is the final step for the formal head transplant for a medical condition which is imminent.

A controversial Italian doctor announced Friday that the world’s first human head transplant was “imminent” and that it would take place in China because his efforts to get backing for the project were being ignored by medical communities and scientists in the United States and Europe.

“The Americans did not understand,” Sergio Canavero said in a press conference in Vienna, Austria. He was discussing a surgery that if it works will be an audacious and near-miraculous therapy that defies decades of scientific wisdom and raises profound ethical questions. It also represents another area in which Beijing is seeking to assume the mantle of global leadership from climate to economic governance.

Canavero said the Chinese government and Ren Xiaoping, a Chinese doctor with whom he is partnering to perform the procedure, would confirm the surgery’s date “within days.” Canavero previously vowed to hold it before the end of the year.

“Chinese President Xi Jinping wants to restore China to greatness. He wants to make it the sole superpower in the world. I believe he is doing it,” said Canavero.

Medical experts said the operation would not be permitted in the U.S. and Europe.

In a phone interview with USA TODAY, Canavero decried the lack of “will” to make the surgery happen in one of those places. “No American medical institute or center would pursue this, and there is no will by the U.S. government to support it,” he said.

Canavero would not divulge the identity of Chinese recipient (head) or the donor (body), who will be a brain-dead patient matched for height and build, but who is otherwise healthy. The recipient will have a head, but not body, that is disease-free.

Technically speaking, from an anatomical standpoint the procedure is a body transplant because the recipient will be keeping his or her head and getting a new body.

When, two years ago, Canavero first announced he would attempt the surgery, Russian national Valery Spiridonov, 33, who suffers from a rare form of paralysis and muscle-wasting disease that will eventually kill him, volunteered for the procedure.

“My family accept me the way I am and tell me that I do not have to change,” he said in a Skype interview from his home outside Moscow late last month. “They want a happy life for me. If I believe this surgery is the answer, they support what I do.”

He said that he knows the surgery sounds like Frankenstein science, but that he needs some kind of “intrusion” to relieve debilitating pain in his spine. “Am I afraid? I am not.”

Spiridonov runs an educational software company from his wheelchair. His internal organs are being squeezed and he finds it hard to breathe. For six months of the year he is confined indoors because Russia’s cold weather affects his circulation.

In the introduction to the 1831 edition of her novel Frankenstein, about a scientist who creates a creature from body parts, Mary Shelley wrote “perhaps the component parts of a creature might be manufactured, brought together and endued with vital warmth.”

What Canavero hopes to accomplish is not much different.

At an estimated cost of up to $100 million and involving several dozen surgeons and medical experts, he will simultaneously sever the spinal chords of the donor and recipient with a diamond blade. To protect the recipient’s brain as it is transferred onto the body — to defy immediate death — it will be cooled to a state of deep hypothermia.

Recipient and donor will placed in a sitting position to facilitate what’s expected to be more about 24 hours of gory, laborious work to separate and then reconnect vertebral bones, jugular veins, the trachea, esophagus and other neck structures. The recipient will be helped to breathe, and blood pumped around the body, with machines. The patient will be kept in drug-induced coma for an unspecified recovery time.

Michael Sarr, a former surgeon at the Mayo Clinic in Rochester, Minn., and the editor of the academic journal Surgery, said Canavero’s procedure radical because doctors “have always been taught that when you cut a nerve the ‘downstream side,’ the part that takes a signal and conducts it to somewhere else, dies. The ‘upstream side,’ the part that generates the signal, dies back a little — a millimeter or two — and eventually regrows. As long as that ‘downstream’ channel is still there, it can regrow through that channel, but only for a length of about a foot.”

This is why, he said, if you amputate your wrist and then re-implant it and line the nerves up well you can recover function in your hand. But if your arm gets amputated at the shoulder, it won’t be re-implanted because it will never lead to a functional hand.

“What Canavero will do differently is bathe the ends of the nerves in a solution that stabilizes the membranes and put them back together. The nerves will be fused, but won’t regrow. And he will do this not in the peripheral nerves such as you find in the arm, but in the spinal chord, where there’s multiple types of nerve channels,” Sarr said.

There has been some success using Canavero’s proposed technique on mice and dogs. In one example, a dog walked after six weeks, albeit with an awkward gait. “Based on the classic thinking about how nerves regenerate it was unbelievable,” said Sarr.

Canavero said Friday that his team has “rehearsed” his technique with human cadavers in China, but there are otherwise no known human trials. He said the 18-hour operation on two corpses showed it was possible to reconnect the spinal chord and blood vessels. Before the full transplant takes place, two brain-dead patients will undergo the surgery.

Most medical experts say it’s a long shot, but even if it the operation works the biggest obstacle may not be the science itself, but whether it should happen at all.

“There are too many risks at this point to go ahead with it,” said Assya Pascalev, a biomedical ethicist at Howard University in Washington. “We don’t have enough data with animal models, sufficient published and peer-reviewed results, and particularly data about mobility and morbidity on the animals that have had the procedure.”

Pascalev said that any groundbreaking procedure — especially its first iteration — is almost certain to face objections and skepticism and requires quite a major leap of faith.

“The first heart transplant, hand transplant, facial transplant: all were met with serious reservations. There are also regulatory concerns. China does not have the same medical standards and requirements that the United States and Europe have.”

She added that there were major unanswered questions about the identity and rights of the recipient after the surgery, such as whether he or she would have the same legal control over any children that the recipient’s new body produced. “It’s not just about a head adjusting to a new body. We might be dealing with a whole new person.”

In the interview, Canavero dismissed these concerns and said that “western bioethicists needed to stop patronizing the world.” He added that China’s receptiveness to hosting the surgery reflected its predominant place in the new global order and that an outdated view of “American exceptionalism” forced him to linkup with the Chinese.

“American exceptionalism” is usually defined as the view that the United States has a more unique and definitive role to play in shaping world history than other nations.

“Who sent America to the Moon? It was Wernher von Braun,” he said, referring to the German national who was an early rocket developer and space-exploration advocate.

Still, James Giordano, a professor of medicine and neurosciences at Georgetown University Medical Center in Washington, agreed with Pascalev that not enough rigorous study has been done to support a procedure with so many risks.

He said patients might be better served if Canavero focused on spinal reconstruction, not transplants. Yet he also gave him some credit for his pioneering work.

“He’s run the ethical flag up the poles and said, ‘Look, I’m not an ethicist, I’m a neurologist and this may be an avant-garde technique, I recognize there is a high possibility for failure, but this is the only way we can push the envelope and probe the cutting edge to determine what works, what doesn’t and why.'”

For Spiridonov, there was a sense of relief after found out that he would not be Canavero’s first human guinea pig. “It would not have changed my hobbies: reading, watching movies. It would not have changed my job, but of course I would have been able to do more. However, I would still essentially like to live a life of the mind,” he said.