Doctor Ready to Perform First Human Head Transplant | Hacker News Reader

Doctor Ready to Perform First Human Head Transplant

newsweek.com

49 pointstdurden50 comments

I'm feeling incredibly bearish on this one. The central nervous system is not meant to be trifled with.

There are way too many questions here. What's the evidence for this? Two papers by two of his collaborators? How are neurons that have already degenerated in the brainstem due to the Werdnig-Hoffmann Disease going to be rescued? How is he going to reconnect different pathways between the brain and spinal cord if they have a different spatial distribution? So is the patient going to have the immune system of the donor body - if so, what does that mean for the head? What evidence is there that the visceral organs are going to be correctly modulated by the brain? What's going to happen to his collaborator's monkeys in a couple years?

I don't see how this is suppose to work when we can not fix quadriplegic people. At the end of the day the only problem that they have is that the nerve connections are damaged. So if we can't fix that how do we move on to something so much more complex like this.

edit: Answer is here under Gemini, which claims to use a unique procedure to fuse the severed nerve bundle together, after doing a very clean cut.

http://surgicalneurologyint.com/surgicalint_articles/heaven-...

> don't see how this is suppose to work when we can not fix quadriplegic people.

folks with spinal cord injuries are often that way not due to injury caused by trauma itself, but due to their bodies reaction after that trauma. Swelling and inflammation near the damage leads to contusion of nervous tissue and the formation of scar-tissue like plaques that reduce the effectiveness of myelin as an electrical material. We can't repair that form of damage yet, only hope to limit it through quick response after trauma.

The HEAVEN paper goes through the steps they are going to take to make sure that the body is not allowed to react in such a way. A very sharp blade is used and a chemical, PEG, is used to refuse the nervous tissue within a small very small time-frame, along with chilling the patient and other protocols.

tl;dr : a spinal cord injury is tricky because the overall amount of bandwidth between the brain and the nervous system is reduced (so-far) irreversibly.

This surgery is tricky (amongst a zillion other reasons) because rather than dealing with a reduction in bandwidth, it's hoped that the brain is plastic enough to be able to deal with the different spatial characteristics of the patients nervous tissue and matching body.

even shorter tl;dr : it's easier to manage an injury you made than one you were handed.

(p.s. tetra/quad/para-plegia are symptoms, not diseases. the causes are numerous and plentiful. i'm only using spinal cord injury as an example because I am more familiar with it than other diseases that cause paralysis)

In that case, could you make two ultra-precise cuts above and below the lesion, and connect the stumps with a piece of the spinal cord of a brain-dead patient, similarly cut? Would that not be worth trying first?

I assume that's the point of the diamond nanoblade: to be able to cut the spinal chords without the sort of extensive, uncontrolled, tissue damage you might see in a quadriplegic.

I came here to say exactly that.

The language he uses in the TEDx talk feels like he has delusions of grandeur ("welcome to heaven", "your lives will never be the same"). Makes me worried there isn't as much substance behind this as he tries to make us believe.

Isn't this a body transplant?

Yea to avoid confusion this should be called a 'below neck body transplant' or something. You can't have a 'head' or a 'brain' transplant.

Do we want to save the head or to save the body. Maybe the former. Maybe...

The most dangerous part of the whole surgery is what happens if something goes wrong midway after they've cut the heads out?

Scenario 1: Irrecoverable scenario where they can't sew the head to the new body. Now what? Will they sew it back to the original body? Let the guy die(What does this even mean at this stage)?

Scenario 2: Head can be put on new body but they can't do it all properly, when and how do they call it quits? What will be the state of the guy? Will they just him?

Other unknown unknowns.

Apart from the fact that the patient has taken a leap of faith, to prefer death over suffering a medical condition all his life. You have to say the doctors involved in this, and you need some really crazy amounts of courage to even attempt something like this.

It definetly seems insane to me, we are not ready. Will we ever be?

I do not imagine any way to face these situations.

The ASTRONOMICALLY MASSIVE ethical issues aside, scientifically and medically speaking, this is pure lunacy.

"Organ" rejection is going to be a huge problem here, as you have the head's immune response fighting with the body's and no previous research has been shown that one will win over the other.

The surgeon has done this on 2 monkey models and there is not yet a long term history of the procedure. There are no verification studies by other groups, AFAIK, that prove his methods work. There are no measures of the health of the monkey in the long term. I believe that the monkeys were all healthy and diseased like the human cases.

Where is the body donor coming from and in what state is that corpse relative to surgery? Was it in an automotive accident 2 hours ago? Too many variables here.

Small monkeys are one thing to freeze down, but a human head is another. Maybe try this on pigs first and see, as their vascular system is comparable in size to ours and they have will be a good extreme case for eating issues and infections that the person will encounter.

What in the everliving hell kind of surgery suite is this going to be?! Holy mother if it is not going to be the most expensive operation in history. The chaos in trying to get all those people in there and in the right places at the right times itself will need to be practiced for months if not a year. Again, porcine models will help with that.

Now, the science aside. The ethical issues are astounding and not easily dismissed. The artificial heart changed our perception of ourselves as what it meant to be human, and if this goes through, this will be just as challenging to our ideas of a human as well. That said, the surgeon sounds like a nut bag that has been writing himself too many painkillers or something. I'd never want this guy to operate on me.

Has there ever been any sort of success at a spinal fusion anything remotely like this? In any vertebrate? This is way past crazy.

According to the article, yes, repeatedly

The key element of fusing the spinal cord together has never been done.

From the article: "Canavero’s collaborator, Xiaoping Ren of Harbin Medical University in China, recently completed a monkey head transplant. And Canavero’s colleague, C-Yoon Kim of the Konkuk University School of Medicine in South Korea published a study in the journal Spinal Cord showing how his team re-established motor movements in mice whose neck spinal cords had been severed and re-fused."

Article says it was done in a rodent.

When an article about software, encryption, the Internet, etc. appears in Newsweek, HN is eager to rip it apart and deconstruct the laughably naive way the author presents these complex systems. HN is quick to point out how the author's numerous forms of severe technical ignorance preclude anything resembling a correct description of the problem, obscure critical facts about the situation, and prevent the reader from drawing any valid conclusions.

When an article about neurosurgery appears in Newsweek, however, everyone has a strong opinion on whether it's a good idea.

Here is the outline of what he's trying to do

http://surgicalneurologyint.com/surgicalint_articles/heaven-...

"Next, Spiridonov’s head will be nearly frozen, ultimately reaching 12 to 15 degrees Celsius, which will make him temporarily brain-dead."

What?! Did I read this wrong?

There's a lot of work being done right now on the practice of bringing body temp down extremely low as a way of making surgery safer and preserving bodies to get them to hospitals. It sounds nuts but it seems like one of the more mainstream parts of this procedure.

there were cases when people after a couple hours in the water under the ice were brought back to live. If i remember the record low body temperature was ~14C.

The 16C case of a toddler wandering outside into the winter that i was able to find right now - http://www.cbc.ca/news/canada/frozen-toddler-s-recovery-a-mi...

That's mammalian diving reflex, though. This is a bit different...

Mammalian diving reflex has nothing to do with the cooling of a body to slow metabolic death.

It has a lot to do with people who spent a couple of hours in water under the ice being revived, though - which was trhway's subject.

150? That's a lot of doctor. snicker

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I find this highly unethical and selfish that the doctor is using a disabled and vulnerable human being as a guinea pig. There is no way that this works. Such a procedure should have been attempted successfully on monkeys several times before being allowed on a human. I suggest everyone read this article in full.

They have performed this surgery on monkeys already (although without attempting to fuse the spinal cord).

The doctor and his colleagues will have performed more attempts on primates before a human attempt, which is why he has an estimated year of operation at 2017.

While I do agree that the doctor may be being selfish in search of fame (or infamy), but shouldn't the human be given the choice to make his decisions? He can't perform basic human functions without assistance much less enjoy other pleasures in life due to his disease.

The candidate's decision-making process isn't impaired and many other people with late-stage cancer often undergo controversial treatments that are not fully tested all the time, even outside of clinical trials [0].

[0] http://www.cancer.org/treatment/treatmentsandsideeffects/cli...

I too find the claims that he can just glue two spinal cord stubs together highly suspect. If this glue worked this well, why are we not trying it on para/quadriplegics? Maybe it has, but I would think this sorta news would have been shouted from the rooftops as it is kinda like curing cancer.

Because para/quadriplegics don't have the benefit of avoiding scarring and other tissue damage by precise cuts on nerves.

What is to stop cutting the scar off and trying new? There should be at least some slack there. Shoot I would lose a vertabrae to the prospect of walking again if i were in that situation.

I suspect neither of us know. I am simply pointing out that you're shooting in the dark here.

Why do you find it unethical and selfish? The patient is volunteering for the procedure, are you ok with removing his autonomy by making this decision for him? Is it ok to let this patient essentially rot away in a wheel chair for the rest of his life, knowing that there is a treatment that might help him?

The knowledge gap between doctors and patients (or researchers and study subjects) is so great that it is very easy for someone to sign up a desperate patient by misleading them. This is why we have such things as institutional review boards to make sure that the risk vs benefit vs chance of success are not too out of whack.

There is nothing in that article that suggests institutional review boards are not involved.

I think what many people might find objectionable is that they believe this doctor is essentially offering false hope to someone who is very desperate.

That too for personal fame. Make it work on monkeys, do it multiple times and see how long they live. Once it works then do it on humans.

Did you read the article? It clearly says that they are backing up their plan with multiple research studies on mice and monkeys.

Why would such a thing be more ethical if performed on a non-consenting monkey than if on a consenting human?

Because animals are not people. Their ethical value, while nonzero, is incommensurate to a human's. It would be ethical to behead ten thousand monkeys if it meant we could cure paralysis.

Human is an animal. It is an Ape from the beginning.

And the first thing that the monkey that actually got its head transplanted on another monkey body was to bite a nearby surgeon, before to fall unconscious and die. So I guess it was painful.

It was not a head exchange, and the monkey that loss its body was not saved.

Would it be ethical to you if 100 Houyhnhnms[1] got cured from paralysis if hundred human lost their head?

Of course, I'm not aware of any Houyhnhnm existing, so this can not be applied.

[1]: https://en.wikipedia.org/wiki/Houyhnhnm

"More ethical" I still agree that we feel this more ethical to harm other species, just like it could be less ethical to harm family than a pure stranger.

But the human is consenting

>>Such a procedure should have been attempted successfully on monkeys several times before being allowed on a human.

From the article:

After all, back in 1970 American neurosurgeon Dr. Robert White conducted the first successful transplant of a head to another body when he operated on a rhesus monkey.

I've read about that. "Successful" might not mean what you would think in that sentence.

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