How the head transplant ended. A patient without a head. Ethical aspects of head transplantation

When Dr. Canavero announced his grandiose project two years ago, the news shocked the scientific world and, of course, the project was criticized. Despite the skepticism of many scientists and surgeons, the Heaven project attracted the interest of thousands and thousands of physicians who wrote to the Italian scientist.

The first human head transplant will take place in China. The team of specialists will be led by Chinese doctor Ren Xiaoping, assisted by Sergio Canavero. Since the project will be funded by the Chinese government, the patient will be a Chinese citizen, and not Russian Valery Spiridonov, as previously planned.

Sputnik Italia learned from Sergio Canavero what results were achieved within the framework of this fascinating, but ethically ambiguous project:

- Please tell us at what stage the Heaven project is?

“In September, we published our first “proof of principle” research in Korea, conducted in collaboration with Rice University in Texas. Research has shown that mice that have been cut spinal cord, as is done with a head transplant, they regain the ability to move. These operations use an improved version of polyethylene glycol (PEG), so that 24 hours after surgery, nerve impulses begin to pass through the incision site again. A dog whose spinal cord was cut and repaired with PEG was able to run again 3 weeks after surgery.

These were early studies, and critics said we didn't have enough statistics. We were told that nerve impulses pass (through the incision site), but we had to prove that nerve fibers reappear at the incision site. In January, we published the first work that used a method for studying tissues and cells called immunohistochemistry. Using this method, we have proven that nerve fibers grow at the site of the incision.

-And what were the next steps?

To obtain sufficient statistical data, we used large rats for further research. The technique used was diffusion tensor imaging (DTI), which allows you to see the fibers without the need to kill the animals. The rats were divided into two groups: the first group received placebo during surgery, and the second group received PEG. A month later, the rats from the second group could move, but the rats from the first group could not. Later we conducted the same experiment on dogs, and the result was similar. That is, we can now say that mice, rats and dogs with a severed spinal cord can regain the ability to move.

- And the first country in the world where surgery will be performed on humans will be China?

— Yes, the Chinese government wants a Chinese specialist to lead the transplant team of doctors. Therefore, in April we announced that, according to the law of the country, I would assist the Chinese neurosurgeon Xiaoping Ren and his team. It won't be long now, and in October you will learn sensational news.

Why can’t the first person be the Russian Valery Spiridonov, who was the first to offer himself for your operation?

— Here you touched on the main essence of my appeal to Russia. I want to emphasize that in Russia there are surgeons capable of performing such an operation, there is a specially equipped hospital, and there is the necessary money. But at the same time, when representatives of very wealthy Russians, billionaires, contacted me, they emphasized their interest in investing in my project, but not in charity. So now I have lost hope of convincing Russian investors to help me find a donor for a transplant that will save Valery Spiridonov. And I appeal to the Russians: Valery, a Russian citizen, will only be saved by an operation in Russia. China, naturally, will save the Chinese, besides Valery is a representative of the white race, and he cannot be transplanted with the body of a Chinese so as not to cause negative psychological reactions.

I officially appeal to the Russian authorities and the Russian people to help me save the Russian citizen Valery Spiridonov. I am ready to assist a team of Russian surgeons during an operation in Moscow. If the authorities are unwilling to intervene, there is another option - crowdfunding. I ask 145 million Russian citizens for financial assistance. There is no other way to save Valery. I ask the Russian people to help save my compatriot. Let Russia, where the great neurosurgeon Surgeon Demikhov began his operations on animal head transplants in the last century, carry out this operation and begin a new era."

For a long time, 31-year-old Valery Spiridonov appeared as the person whose head would be the first to be transplanted onto a new body during a unique operation that Italian neurosurgeon Sergio Canavero planned for the end of 2017.

But in Lately Canavero increasingly and cautiously hinted that Spiridonov’s priority was in question. The fact is, the surgeon has finally decided on the location of the operation: it will take place in Harbin, China, where Canavero will be assisted by a large team of Chinese doctors led by transplantologist Ren Xiaoping.

Since the transplant will take place in China, Valery Spiridonov will not be the first patient, Canavero confirmed recently in an interview with LLC OOM. - He will be a Chinese citizen. This is due to completely understandable circumstances. We will have to look for donors among local residents. And we cannot give snow-white Valery the body of a person of a different race. We cannot yet name the new candidate. We are in the process of choosing.

Canavero named the cost of the operation - $15 million - and planned it for Catholic Christmas, December 25, 2017. But two months before this date, he is going to conduct a trial operation on patients who are in a state of clinical death. This will be done to hone the technique of the most complex surgical manipulation.

Meanwhile, Canavero says significant progress has been made in medical experiments on animals.

Firstly, Canavero demonstrated a two-headed “mutant” - it was created when the head of a small one was sewn to the neck of a large laboratory rat. Secondly, on June 14, a report on another experiment by Canavero and his friend Ren Xiaoping was published in the scientific journal CNS Neuroscience and Therapeutics. Surgeons cut the spinal cord of 15 laboratory mice, the wounds of 9 of them were treated with polyethylene glycol - a substance that, according to Sergio Canavero, should regenerate nerve fibers and restore the patency of signals. And another 6 animals from another group - the control group - were treated with saline solution. Moreover, after 28 days, all 9 rodents treated using the Canavero method began to recover and began to move their limbs (unlike the poor fellows from the control group).

This is a sign that we are on the right track,” said the Italian neurosurgeon.

However, the luminaries of world science are still skeptical about Canavero’s idea.

They say the stumbling block is to reconnect the ends of the cut spinal cord into a single whole. The experience with the two-headed rat has nothing to do with this at all, because Canavero did not try to fuse the spinal cord, but simply connected blood vessels, which allowed a second head to live on the body of another rat. Much more successful experiments of this kind were carried out by the Soviet scientist Vladimir Demikhov back in the 50s of the last century. Canavero's rat died after 6 hours, and Demikhov's two-headed dogs lived for about a month.

Regarding the article published in CNS Neuroscience and Therapeutics, there is no evidence that the spinal cord of laboratory animals was cut completely and not partially. All of Canavero's achievements are so far visible only on paper. Until now, he has not presented to the scientific world a single animal that would restore motor functions after a complete rupture of the spinal cord.

Before you announce a human head transplant, show me a dog walking on stage with a donor body, says Paul Zachary Myers, Ph.D. in biology and professor at the University of Minnesota. - If Dr. Canavero’s technology had worked, we would have already been presented with such evidence.

So maybe it’s for the best that Valery Spiridonov avoided the fate of becoming Canavero’s first test subject?

In other words, another experiment was conducted. It lasted 18 hours. It was carried out by the Harbinsky team medical university led by Dr. Ren Xiaoping. During the procedure, it was possible to restore the spine, nerves and blood vessels. And without this, such a transplant is out of the question.

It is appropriate to recall that sensational reports about her did not appear today. At first, Sergio Canavero was going to hold it in Germany or Great Britain. And the first patient was supposed to be a programmer from Vladimir Valery Spiridonov, suffering from a severe genetic disease that deprives a person of the ability to move. Some time passed, and it was announced that not Valery Spiridonov, but presumably 64-year-old Chinese Wang Hua Min would be the first person to undergo such an operation, since Wang was in a more serious condition than Valery, and China had joined this project.

In September 2016, a neurosurgeon published a video showing animals (a mouse and a dog) undergoing a trial operation. The experiment used polyethylene glycol, which was injected into the affected areas of the spinal cord and helped restore connections between thousands of neurons. Polyethylene glycol, the same bioglue on which Canavero pinned his hopes from the very beginning, is capable of gluing nerve endings, which is necessary for this transplantation. And here's Canavero's new message: live human head transplantation will take place in the near future.

Technically the operation is feasible. But not resolved main question: effectiveness of restoring nerve contacts between the donor’s head and body

At the request of RG, the director of the National Medical Research Center for Transplantology and Artificial Organs named after Shumakov, Academician Sergei Gauthier, comments on the message:

Progress cannot be stopped. But when it directly concerns a person’s health and life, one should under no circumstances rush. The first is always, one way or another, associated with risk. And the risk must be justified. Technically, the operation of transplanting the body to the head is quite feasible. By the way, it is the body to the head, and not vice versa. Because the brain is identity, it is personality. And if the brain dies, there is nothing to do. There is no point in transplanting someone else's head to a still living body; it will be a different person. The question is whether it is possible to help this head containing human personality, with the help of a transplant of some donor body, so that this head is supplied with blood, oxygen, can receive nutrients from digestive system this body. Technically, I repeat, such an operation is quite feasible. But the main question has not been resolved: the effectiveness of restoring nerve contacts between the donor’s head and body. And conducting experiments on corpses, on animals about which there are reports, is a normal, generally accepted course of events, a generally accepted development of the methodology.

Expert: “This is very nice PR!”

Italian surgeon Sergio Canavero performed a human head transplant in China. According to him - successful. Meanwhile, the public is perplexed, because we are talking about a head transplant to a corpse. Why transplant a head into a corpse?

Canavero became famous in Russia after programmer Valery Spiridonov, suffering from a serious illness,...

Now Canavero has refused this operation. According to Spiridonov, the surgeon received funding specifically in China and specifically for a certain type of experiment...

Russian doctors called the current news about a “successful head transplant” a beautiful PR campaign.

From a PR point of view, this is a very smart move, they are pure adventurers,” Dmitry Suslov, head of the laboratory of experimental surgery of the Pavlov State Medical University of St. Petersburg, told MK. “In fact, the operation that Canavero performed was a training presented as a world sensation.

The expert said that similar training operations are carried out by all transplant surgeries in any country in the world that can boast of success in this most complex field of medicine. Moreover, it is mainly young doctors who practice on corpses, who are still afraid to let near a living body.

“We can’t talk about any success here,” Suslov noted. “They took a dead head and sewed it to a dead body.” The only thing we can talk about here is that they worked accurately and sewed it in a purely technically competent manner.

Russian doctors also do not dare talk about any discoveries during the operation. Most of the actions that are needed to sew a head to a body should be perfected to the point of automaticity by any self-respecting surgeon. Every doctor who performs operations on the heart and blood vessels should do the vascular suture practically with his eyes closed. Sutures on large nerves are for neurosurgeons.

As for the past “merits” of the Canavero team, which was also noisily discussed by the whole world - transplanting a head to a monkey, here the doctors also just shake their heads skeptically. According to them, maintaining life in the severed head of an animal is an experiment from the beginning of the last century. The then researchers in white coats were very good at such manipulations.

However, our transplantology still left a small chance of victory in the future for foreign adventurers. Theoretically, it is possible to transplant a head to a living person. And there is even a chance that after the operation both the head and the rest of the body will function normally. But to do this, you will have to make a real scientific breakthrough - learn how to fuse spinal cord neurons.

If someone manages to do this, it will Nobel Prize, says Suslov, “A huge number of people with spinal injuries will have a chance to get back on their feet and live a full life. But so far such experiments have only been carried out on rats. And at the moment we have only a partial understanding of how this should be done.

The science that studies organ transplantation is called transplantology. Just a few decades ago, the movement of tissue from one organism to another was considered something incredible. In modern surgical practice, transplantation internal organs widespread. This is mostly practiced in developed countries with high level medical support. Liver, kidney, and heart transplants are successfully performed. IN last years doctors began performing limb transplants. Despite the high professionalism of surgeons, some operations end in failure. After all, the body does not always “accept” foreign organs. In some cases, tissue rejection may occur. Despite this, a famous practicing surgeon from Italy decided to take an incredible risk. The doctor is planning a head transplant operation. To many, this idea seems incredible and doomed to failure. However, surgeon Sergio Canavero is confident that head transplantation will be a huge breakthrough in medicine. To date, studies and attempts have been carried out to implement this manipulation on laboratory animals.

Head transplant surgery: description

In 2013, an Italian surgeon made a sensational statement to the whole world. He planned an operation to transplant the head of a living person onto the body of a corpse. This procedure has become of interest to people suffering from serious diseases that cause immobilization. Surgeon Sergio Canavero has already contacted the intended head donor. He turned out to be a young man from Russia. The patient was diagnosed with severe pathology nervous system- congenital spinal muscle atrophy. At the moment, Valery Spiridonov is 30 years old. Despite quality care, his condition is rapidly deteriorating. The only functioning part of the patient's body is the head. Valery Spiridonov is aware of all the risks of the planned event, but he agrees to go for it. The first human head transplant operation is scheduled to take place in 2017.

Sergio Canavero estimates that the transplant will take about 36 hours. To carry out all stages of the operation, more than 100 qualified surgeons will be needed. During the transplant, doctors will change several times. Head transplant is very difficult surgical intervention. To carry it out successfully, you will need to connect many vessels, nerve fibers, bones and soft tissues of the neck. The most difficult stage of the operation will be the fastening of the spinal cord. For this purpose, a special glue based on polyethylene glycol was produced. Thanks to this substance, the growth of neurons occurs. Each stage of the operation is considered risky and may end fatal. However, this does not frighten patient Valery Spiridonov. The doctor who planned the sensational operation is also optimistic. Canavero is almost confident of a favorable outcome of the procedure.

Ethical aspects of head transplantation

A topic such as human head transplantation causes heated emotions and controversy not only among doctors. In addition to the difficulties in performing a transplant and the risks to the patient’s life, there is another side to the coin. Thus, many people consider the planned procedure unacceptable from religious and ethical points of view. Indeed, it is difficult to comprehend that the head of a living person will be separated from the body and attached to the neck of a dead person. However, people suffering from severe progressive pathologies do not have to think about ethics. For many patients, a head transplant will be an incredible miracle. After all, people doomed to disability will have a new body. Due to the fact that the operation has not yet been carried out and its outcome is unknown, the public has a controversial attitude towards this issue.

Research

The first research in the field of head transplantation was the experiment of scientist Charles Guthrie. It was held in 1908. The experiment involved transplanting a second head onto the dog's neck. The animal did not live long, but it was possible to note a slight reflex activity of the transplanted body part.

In the 1950s, Russian scientist Vladimir Demikhov managed to achieve better results. Although his laboratory animals also did not survive long after transplantation, the transplanted heads were fully functional. Demikhov significantly reduced the time of hypoxia of separated tissues. Similar operations on dogs were later carried out by Chinese scientists. In the 1970s, White transplanted a head into a monkey. At the same time, the animal’s sense organs functioned.

In 2002, experiments were conducted on laboratory rats in Japan. As for the planned intervention, polyethylene glycol was used. The dissected tissues were refrigerated to prevent cell death. In addition, Sergio Canavero stated that his latest research involving monkeys has recently resulted in a head transplant. It ended happily. The scientist evaluates positive result as a signal to conduct an experiment on humans. If the public and scientific community approve of this project, people will soon learn about its results.

Human head transplant: the opinion of scientists

Despite the Italian surgeon's positive attitude, scientists and doctors do not share his enthusiasm. Most of them do not believe in the success of the venture. In addition, many doctors believe that head transplants are unacceptable for ethical reasons. The pessimism of colleagues does not affect the scientist’s decision in any way. Canavero recently said that the transplant would take place with the consent of the state board members.

For what diseases is surgery necessary?

At the moment, it is too early to say whether such an operation will be performed in practice in the future. However, if the outcome is favorable, the scientist will experience incredible success. If head transplantation becomes possible, many patients will gain healthy bodies. Indications for transplantation include:

Tetraplegia developed against the background of cerebrovascular accident.
Muscular spinal atrophy.
Spinal cord injuries at the level of the cervical vertebrae.

Difficulties of surgical intervention

A head transplant is a technically complex procedure. During its implementation, doctors may encounter many difficulties. Among them:

Tissue death during head separation. To prevent this, scientists intend to cool the head to 15 degrees. At the same time, neurons must maintain their viability.
Risk of rejection of the transplanted body part.
Long-term connection of the spinal cord after surgery. In order for the nerve tissue to be correctly mapped, the patient is planned to be placed in a comatose state for 1 month.

Possible outcomes of head transplant surgery

Considering that such operations have not been performed on people before, the outcome of this procedure is impossible to predict. Even if all manipulations are performed correctly, it is unknown how this experiment may end. Scientists do not rule out the possibility that the spinal cord will be damaged and the patient will not be able to move. However, even in this case, the operation will be an incredible breakthrough in transplantation.

Head transplant cost

How much does a head transplant cost and when will it be introduced into practice? It is not yet possible to answer these questions. Nevertheless, some information is available. Thus, an assessment of the equipment and necessary materials for the planned transplantation showed that the cost would be about 11 million dollars. In addition, in case of a favorable outcome, long-term rehabilitation will be required. According to the Italian scientist, the patient will be able to move independently a year after the operation.