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Xiaoping Ren, Sergio Canavero
  1. Harbin Medical University, Harbin, China

Correspondence Address:
Sergio Canavero
Harbin Medical University, Harbin, China

DOI:10.4103/2152-7806.175074

Copyright: © 2016 Surgical Neurology International This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Ren X, Canavero S. Human head transplantation. Where do we stand and a call to arms. Surg Neurol Int 28-Jan-2016;7:11

How to cite this URL: Ren X, Canavero S. Human head transplantation. Where do we stand and a call to arms. Surg Neurol Int 28-Jan-2016;7:11. Available from: http://surgicalneurologyint.com/surgicalint_articles/human-head-transplantation-where-do-we-stand-and-a-call-to-arms/

Date of Submission
21-Nov-2015

Date of Acceptance
27-Nov-2015

Date of Web Publication
28-Jan-2016

Ever since being announced in 2013, the HEAVEN head transplant initiative – also known as allogeneic head body reconstruction, the GEMINI spinal cord fusion protocol and the first head transplant procedures in mice[ 1 2 3 5 6 7 8 ] have received scathing remarks from several official medical, surgical, and ethical bodies.[ 3 ]

Medical history shows us that many of the “quantum leaps” almost always fly in the face of conventional wisdom. Today's standard of care was yesterday's experimental treatment, and before that, in many cases, it was one man's visionary idea. The history of medicine includes many examples of ideas that were initially ridiculed or rejected by the medical establishment but that later became widely adopted, thanks to the courage of researchers and clinicians who stood by their ideas, often in the face of withering criticism from their colleagues. Notable examples would include Semmelweiss (antiseptic handwashing), Gruentzig (balloon angioplasty), Rous (viruses and cancer), Marshall (Helicobacter pylori and ulcer), Prusiner (prions), Pasteur (germs), Mendel (heredity), and many others. The last in the list is HEAVEN.

The question arises spontaneously: Why? Why so much acrimony for a lifesaving procedure?

The reason is psychological: HEAVEN opens the Pandora's box of medical failures.

“Despite biomedical research blossoming in terms of accumulated data, evolving technologies, and published articles… few advances in biomedical science materialize into human applications that affect health; even when successful, the translation sometimes takes decades… as proposed discoveries accumulate, a major challenge is how to promptly translate them into something useful. The current pipeline remains inefficient… effective application in saving lives and improving health has been limited. The excuse that not enough time has passed is not really satisfactory… human genetics research has received tremendous funding… few lives have been saved because of accumulated human genetics knowledge to date, and future prospects (e.g., extension to personalized and precision medicine) also are not promising… intellectual fascination in neuroscience for many decades has led to few new practical applications. It is unclear whether newly announced efforts in this… discipline will fare any better… even the most recent ones, e.g., optogenetics are already a decade old… most Nobel prizes in medicine have been given recently for discoveries that offer brilliant mechanistic insights, but have not yet moved (and may never substantially move) the dial of life expectancy.”[ 4 ]

This is the state of affairs in biomedicine in the early 21st century. Medicine at large has failed for chronic conditions or is still stuck with gross procedures (injecting insulin for diabetes - since 1922). The only bright spot – infectious diseases – is losing its sheen, as resistance is mounting around the world to available antibiotics. Acute care medicine - which is often lifesaving - is equally often trailed by long-term disability. And of course, bioengineering advances cannot be conflated with biochemical medicine.

Had “brilliant mechanistic insights”[ 4 ] proven “brilliant,” we would be free – or on the way to – of the major killers that affect humankind. There would be no need for a full body exchange.

HEAVEN bears brutal testimony to this simple fact. When you have to change a body because you cannot fix it, that is a sign of failure. Actually, the whole field of transplantology attests to the fact that our biochemical insights have led nowhere, despite vast amounts of money spent over the past 50 years! Since we cannot reverse a biological process gone awry, we are left with little else than replacing this or that organ.

Unfortunately, humility is not a part of the medical lore.

No one in the media and society at large truly grasped this fact: HEAVEN stands for failure.

Whose fault is it?

There are several parties at fault, and it would be too long a list, but standing at the very top is the current peer review system that vets research to be published: “A major advance may be difficult to express in primary ‘original’ articles reviewed by other similar-thinking specialists. The ability to break loose from the shackles of narrowly focused specialists who thwart out-of-the-box ideas may characterize major disruptive innovation.”[ 4 ] Had it been for the specialists of the time, no airplane would be flying over our heads presently, since heavier-than-air flying vehicles were deemed impossible in 1900. Moreover, many other current technologies equally apply (a medical favorite: Mullis’ polymerase chain reaction).

So what is the solution?

Involving private entrepreneurs is one,[ 4 ] since “they have strong reasons to generate truly working solutions and effective interventions rather than simply publish articles and obtain grants.” Is it so?

Founded in 2012, Breakthrough Prizes are the richest prizes in science, bankrolled by Silicon Valley billionaires, including Google's Sergey Brin, Facebook's Mark Zuckerberg, 23 and Me's Anne Wojcicki, Alibaba's Jack Ma, and DST Global Milner. This year's prizes were awarded for optogenetics research and an assortment of genetic mutations that have not changed the prognosis of the related conditions an iota (https://www.newscientist.com/article/dn28461-glitziest-science-prize-hands- out-21m-to-1300-top-researchers). This means that the billionaires still rely on the traditional peer review process. And that is a setback to properly financing breakthrough science.

This is not surprising. As the world knows, in June 2015, the two authors delivered their combined talks to the AANOS/ICS annual meeting in Annapolis, Maryland. Unfortunately, the science behind spinal cord fusion and other aspects of head transplantation were basically unknown to the audience and - one can safely conclude - to the cadres of critics (and reviewers), despite seven papers published in both SNI[ 1 2 3 ] and Central Nervous System Neuroscience and Therapeutics.[ 5 6 7 8 ] Even Dr. White's work has been grossly misconstrued: Ethical criticisms were both unsupported and populist.

Happily, on August 27, 2015, Xinhua, China's official news agency announced the start of the cooperation between the two authors toward the first human head transplantation. A plan has been laid down that involves experimentation with brain-dead organ donors. The manufacturing of the GEMINotome, an ultra-sharp nanometer-grade blade and of a negative pressure micro connector for polyethylene glycol circulation, is a part of this endeavor. In the meantime, scientists from the Institute of Theoretical and Experimental Physics in Moscow (Prof. Maevsky and Orlova) have volunteered their know-how to boost the HEAVEN neuroprotection protocol. Health professionals from all around the world, including the USA, have offered to be a part of the transplant team.

Thus, it is most unnerving that no patients’ association ever contacted any of us, likely advised against by “academic critics,” the same kind of “experts” billionaires rely upon.[ 9 ]

Hence, we thank this journal and its editor in allowing us to make its readership apprised of this simple fact: that academic arrogance once again is stifling scientific innovation.

We urge all those interested, and above all those who stand to benefit the most, the patients, to look at the facts and start funding for our project. At the same time, all unbiased physicians who would want to independently test several aspects of this paradigm are urged to contact us.

HEAVEN is growing into a major international collaboration. In the meantime, people are dying because we doctors failed. This is a time for humility. But also, a time to act. Doctors, patients, and funding bodies (including well-meaning but naive billionaires), together.

References

1. Canavero S. Commentary. Surg Neurol Int. 2015. 6: 103-

2. Canavero S. HEAVEN: The head anastomosis venture project outline for the first human head transplantation with spinal linkage (GEMINI). Surg Neurol Int. 2013. 4: S335-42

3. Canavero S. The “Gemini” spinal cord fusion protocol: Reloaded. Surg Neurol Int. 2015. 6: 18-

4. Ioannidis JP. Is it possible to recognize a major scientific discovery?. JAMA. 2015. 314: 1135-7

5. Ren X, Laugel MC. The next frontier in composite tissue allotransplantation. CNS Neurosci Ther. 2013. 19: 1-4

6. Ren XP, Luther K, Haar L, Wu SL, Song Y, Shan JG. Concepts, challenges, and opportunities in allo-head and body reconstruction (AHBR). CNS Neurosci Ther. 2014. 20: 291-3

7. Ren XP, Song Y, Ye YJ, Li PW, Han KC, Shen ZL. Allogeneic head and body reconstruction: Mouse model. CNS Neurosci Ther. 2014. 20: 1056-60

8. Ren XP, Ye YJ, Li PW, Shen ZL, Han KC, Song Y. Head transplantation in mouse model. CNS Neurosci Ther. 2015. 21: 615-8

9. Canavero S, Bonicalzi V. Fall of the Titans. The Demise of Basic Neuroscience Research. Engineering. 2015. 1: 4-

5 Comments

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    Dr. Miguel A. Faria

    Posted February 5, 2016, 8:23 pm

    Drs. Xiaoping Ren and Sergio Canavero bring up some good points worthy of consideration in their “call to arms.” And from the outset let me admit I’m admirer of Dr. Canavero because like his medical heroes, Semmelweiss, Gruentzig, Marshall, etc., he has defied convention in his pursuit of free speech and freedom in the pursuit of applied science.This is important because there is an authoritarian trend permeating not only the popular culture (political correctness) but also the scientific establishment. Dissenting voices are being silenced by political correctness intolerance, and lack of funding of their research, if they go against the grain.(2,4) This is gradually becoming reminiscent of the totalitarian orthodoxy of the Ministry of Truth in George Orwell’s masterpiece, 1984.(1)

    Are skeptics of this authoritarian trend aware that some “progressive academicians” have made calls towards the imputation of mental illness to scientists who do not embrace scientism or who dissent against scientific opinions supposedly established by consensus?(3)

    Likewise, a ring of 20 scientists are demanding that dissenters of climate change, “climate dissenters,” be prosecuted under the Racketeer Influenced and Corrupt Organization Act (RICO), a law that was designed to prosecute organized crime figures and drug dealers in the United States. It turns out that it is the hypocritical leader of these intolerant scientists calling for prosecution of their colleagues who turn out to be corrupt, using taxpayers money for partisan politics and possibly his and his family personal use.(5)

    All of this is happening but we are too busy to notice! But Dr. Canavero brings all these issues to the forefront and makes us notice.

    It does not matter what one believes by intuition about the HEAVEN project. Dr. Canavero has made us think about the need for freedom in science, awareness of deficiencies in the peer-review process, the need for impetus and future re-direction of scientific research, and even the need to re-examine the status of neural regeneration in brain and spinal cord tissue, as well as in the implications of this work to medical ethics.(6,7)

    What does matter is whether the project is backed by science; whether the project has the potential to be beneficial to humanity at large and to the individual patients in particular; whether the funding is private (the best option); whether the patients will have full informed consent — all of these factors would determine whether the project is a moral undertaken from the perspective of sound science and medical ethics.

    I have not yet read any persuasive treatise explaining why Drs Canavero and his colleagues should be dissuaded from their research, and why they should be silenced. Yes, I have read intolerant and unwarranted criticism of Surgical Neurology International for publishing his work. At the same time I believe Dr. Canavero should do the utmost when the time comes to justify the procedure and assure us he acts upon the moral precepts of the individual-based ethics of Hippocrates — aiming towards progress but also at first doing no harm.(6,7)

    References

    1) Orwell G. 1984. Norwalk, CT, Easton Press edition, 1992.
    2) Blaylock RL. When Rejecting Orthodoxy Becomes a Mental Illness. HaciendaPublishing.com, August 15, 2013. Available from: http://www.haciendapub.com/articles/when-rejecting-orthodoxy-becomes-mental-illness-russell-l-blaylock-md
    3) Van der Linden S. What a Hoax. Scientific American Mind, September/October 2013.
    4. Faria MA. Liberal Orthodoxy and the Squelching of Political or Scientific Dissent. HaciendaPublishing.com, August 19, 2013. Available from: http://www.haciendapub.com/articles/liberal-orthodoxy-and-squelching-political-or-scientific-dissent-miguel-faria-jr-md
    5. Tuttle I. Getting Rich off Climate extremism. National Review, October 1, 2015. available from: http://www.nationalreview.com/article/424875/getting-rich-climate-extremism-ian-tuttle
    6. Faria MA. The road being paved to neuroethics: A path leading to bioethics or to neuroscience medical ethics?. Surg Neurol Int 07-Oct-2014;5:146. Available from: http://surgicalneurologyint.com/surgicalint_articles/the-road-being-paved-to-neuroethics-a-path-leading-to-bioethics-or-to-neuroscience-medical-ethics/
    7. Faria MA. Medical Ethics of Hippocrates or Population-Based Bioethics — A Symposium based on the Interview of Dr. Miguel A. Faria by Kerry Sheridan, Agence France-Presse. Available from:  http://www.haciendapub.com/articles/medical-ethics-hippocrates-or-population-based-bioethics-%E2%80%94-symposium-based-interview-dr-mig

    Reply
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    James Ausman

    Posted February 12, 2016, 4:31 pm

    Congratulations to you both on advancing the probes into the unknown. As from the time people believed the world was flat to the persecution by the church of Galileo for his beliefs in a round world to human advances into space exploration and now the recent revelation of the Gravitational waves and its wave spectrum, these are all discoveries that will generate new knowledge of life and its existence and the universe. So, too, the Gemini project is exploring new areas of the nature’s species and science that makes us insecure in the contemplation of the inferiority and humility of human beings in the great unknown which we face. Could this feeling of insecurity about the unknown and ourselves create the resistance to the exploration of this unknown? Have we established “review panels” of experts that frustrate creativity and imagination, which we need to generate the ideas of the future and instead instituted a collectivist mediocrity of thinking and, thus, the rejection of innovation?

    Reply
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    Ramon Migliorisi

    Posted July 11, 2016, 11:56 pm

    “In 1970, the first cephalosomatic linkage was achieved in the monkey. However, the technology did not exist for reconnecting the spinal cord, and this line of research,”
    Does the technology exist now?. If so, why dont´try first on severely handicapped cuadriplegics, I believe this is a fair question

    Reply
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    Eduardo Fernandez

    Posted July 22, 2016, 9:57 am

    I absolutely think that it is not yet the time right for head and spinal cord transplantation on humans. In some place in the world it could be possible to organize, for example, the transplantation of two heads and, why not, four hands and four legs, and perhaps what would be capable of doing such a man. Probably for such operation more than 150 people should be necessary like also a lot of more money than for the projected only one head transplantation. The problem is not to launch “innovative” -really unrealistic- ideas but to propose “realistic good ideas” with sufficient scientific supports. Furthermore, if the project is unrealistic any other social and ethical considerations are misplaced.
    If the problem of fusing the spinal cords and peripheral nerves of the animals is considered solved, using sealants within minutes, and then this solution justify the passage to humans, I would like to propose experimental surgical transplantations, less terrific of that of the head, but that could be the basis for further more terrific transplants. I am the neurosurgeon who implanted the first bionic hand able to feel (1) and for many years I practiced peripheral nerves surgery and animal experiments about peripheral nerves and spinal cord regeneration (2-6). Then my proposal is to consider less complex transplantations, in comparison with that of the head, by applying what is considered the key to the spinal cord fusion, peripheral nerves fusion (and, why not, the optic nerve fusion in total eye transplantation for the blind), that is the use of a sharply divided spinal cord or peripheral nerves (and also optic nerve) in the donor and recipient and then the approximation and fusion of the donor and recipient nerves using sealants within minutes. Therefore, the following two options could be considered: a) to transplant a donor arm to a hand amputated patient; b) to tranplant a total eye as hypothesized in 1992 by the same author. If these experimental surgeries would be successful in a consistent number of patients then it would be possible to increase the complexity of transplantations to arrive, but not in 2017, to spinal cord, and perhaps head transplantation on humans. The call to humility is valid for everybody, not only for those accused of making strong objections but also for people that cause such strong objections by virtue of what appears like a reckless proposal.

    1) Raspopovic S, Capogrosso M, Petrini F, Bonizzato M, Rigosa J, Di Pino G, Carpaneto J, Controzzi M, Boretius T, FERNANDEZ E, Granata G, Oddo CM, Citi L, Ciancio AL, Cipriani C, Carrozza MC, Jensen W, Gugliemelli E, Stieglitz T, Rossini PM, Micera S: Restoring Natural Sensory Feed-Back in Real-Time Bidirectional Hand Prostheses. Science Translational Medicine, Feb. 5, 6 (222):222ra19, 2014 doi:10.1126/scitranlmed
    2) Facchiano F, Fernandez E, Mancarella S, Maira G, Miscusi M, D’Arcangelo D, Cimino-Reale G, Capogrossi MC, Pallini R: Promotion of Regeneration of Corticospinal Tract Axons in Rats with Recombinant Vascular Endothelial Growth Factor Alone and Combined with Adenovirus Coding for this Factor. J Neurosurg 97:161-168, 2002
    3) Fernandez E, Di rocco F, Lauretti L, Gangitano C, Del Fa A, Massimi L, Maira G, Pallini R: Reinnervation of Extraocular Muscles by Facial-to-Oculomotor Nerve Anastomosis in Rats: Anatomic Nuclear Changes. Neurosurg 53:409-415, 2003
    4) Fernandez E, Lauretti L, Denaro L, Montano N, Doglietto F, Novegno F, Falchetti ML, Tufo T, Maira G, Pallini R: Motoneurons Innervating Facial Muscles After Hypoglossal and Hemihypoglosssal-Facial Nerve Anastomosis in Rats. Neurol Res 26:395-400, 2004
    5) Pallini R, Ricci Vitiani L, Bez A, Casalbore P, Facchiano F, Di Giorgio Gerevini V, Falchetti ML, Fernandez, Maira G, Peschle C, Parati E: Homologous Transplantation of Neural Stem Cells to the Injured Spinal Cord of Mice. Neurosurgery 57: 1014-1025, 2005
    6) Fernandez E, Mannino S, Tufo T, Pallini R, Lauretti L, Albanese A, Denaro L: The adult “paraplegic” rat: treatment with cell graftings. Surg Neurol 65: 223-237, 2006

    Reply
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    Allisons9162

    Posted November 29, 2016, 1:49 am

    Dr. Ren and Dr. Canavero,

    I am a undergraduate senior in college in the United States and I have been researching the work you both have conducted for the past few weeks. I have thoroughly enjoyed learning about the procedure and look forward to seeing more advancements on head transplantation in the future. I believe this procedure would be an amazing opportunity for patients with terminal prognoses. I do have the ethical concern that one day greedy individuals will initiate the ideology of receiving a young, beautiful body… Despite the negativity proposed to you both, the positive possibilities far outweigh the bad. Always remember, yesterday’s experiments are today’s standards.

    Reply

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