Human head transplant: Controversial procedure successfully carried out on corpse; live procedure “imminent”

We’re still an incredibly long way from the sci-fi promise of full, live head transplants but scientists have reportedly taken a step in that direction. 

At a conference in Vienna earlier today, Italian Professor Sergio Canavero claimed that the world’s first human head transplant had been carried out on a corpse in China in an 18-hour operation, performed by Dr Xiaoping Ren and his team at Harbin Medical University. Ren famously grafted a head onto the body of a monkey last year. 

During the conference, Professor Canavero said the first human head transplant had been “realised” and said an operation on a live human is sert to take place “imminently”. However, the claims have not been fully confirmed.

Canavero added: “The first human transplant on human cadavers has been done. A full head swap between brain dead organ donors is the next stage. This is the final step for the formal head transplant.”

When lead doctor Canavero made his initial proposals in 2016, he said he planned to have the surgery completed before the end of 2017, and most likely in December. 

Earlier this year, the proposed first patient for the surgery – Valery Spiridonov – pulled out, saying he would no longer be taking part in the experiment after Dr. Canavero admitted he couldn’t promise the surgery would help Spiridonov walk again. Spiridonov has Werdnig-Hoffmann Disease, a genetic disease that breaks down muscles and kills nerve cells in the brain and spinal cord.

Instead, Dr Canavero said he would be looking for a Chinese volunteer in April, after signing up Chinese surgeon Dr. Xiaoping Ren of Harbin Medical University to help him carry out the procedure, and this is said to have delayed things. The surgery is now not expected to take place until early 2018. These reports have not been confirmed, though, and Alphr has contacted Dr. Canavero’s press team for clarification. 

But just how feasible is a human head transplant? Is it the stuff of science fiction, or does it have a basis in current scientific thinking? Read on for everything you need to know about this most alarming scientific development. 

What is the human head transplant?

A human head transplant is exactly what it sounds like – taking one living head and putting it onto a new body.

But actually, that’s a little misleading. In real terms, it’s a body transplant, as the head will be gaining a new body to control. However, as the term “whole body transplant” is already used to mean transferring the brain between bodies, calling it a “head transplant” makes it clear that the whole head is to be switched, brain included.

Until recently, a head transplant seemed totally implausible, but the Italian scientist Dr Sergio Canavero believes it’s possible and intends to conduct the first surgery in 2017.

How does Canavero’s human head transplant work?

Canavero outlines the procedure in detail here, but these are the basics of the process. Remember: don’t try this at home, kids.

The donor body and the head to be attached are first cooled down to 12-15˚C to ensure that the cells last longer than a few minutes without oxygen. The tissue around the neck is then cut, with the major blood vessels linked with tiny tubes. The spinal cord on each party is then severed cleanly with an extremely sharp blade.

At this point, the head is ready to be moved, and the two ends of the spinal cord are fused using a chemical called polyethylene glycol, encouraging the cells to mesh. This chemical has been shown to prompt the growth of spinal cord nerves in animals, although Canavero suggests that introducing stem cells or olfactory ensheathing cells into the spinal cord could also be tried.

After the muscles and blood supply are successfully connected, the patient is kept in a coma for a month to limit movement of the newly fused neck, while electrodes stimulate the spinal cord to strengthen its new connections.

Following the coma, Canavero anticipates that the patient would immediately be able to move, feel their face and even speak with the same voice. He believes physiotherapy would allow the patient to walk within a year.

He explains his suggested methods in the TED talk below.

https://youtube.com/watch?v=FmGm_VVklvo

What does the scientific community make of the human head transplant?

Sceptical would be a nice way of putting it. Horrified would, in most cases, be more accurate.

Dr Hunt Batjer has attracted headlines for being particularly blunt: “I would not wish this on anyone. I would not allow anyone to do it to me as there are a lot of things worse than death.”

Dr Jerry Silver witnessed the 1970s monkey head transplant experiment – more on which later – and describes the procedure as “bad science”, adding that “just to do the experiments is unethical”. This is a particular blow to Canavero, as he states that Silver’s own work in reconnecting rats’ spinal cords should give hope to the human head transplant. Silver dismisses this: “To sever a head and even contemplate the possibility of gluing axons back properly across the lesion to their neighbours is pure and utter fantasy in my opinion.”

Dr Chad Gordon, professor of plastic and reconstructive surgery and neurological surgery at Johns Hopkins University, agrees that Canavero’s claims are scientifically implausible. He told BuzzFeed: “There’s no way he’s going to hook up somebody’s brain to someone’s spinal cord and have them be functional.”

“On the conservative side, we’re about 100 years away from being able to figure this out,” he continued. “If he’s saying two, and he’s promising a living, breathing, talking, moving human being? He’s lying.”

Dr Paul Myers, associate professor of biology at the University of Minnesota at Morris, puts it even more explicitly: “This procedure will not work… Try it with monkeys first. But he can’t: the result would be, at best, a shambling horror, an animal driven mad with pain and terror, crippled and whimpering, and a poor advertisement for his experiment. And most likely what he’d have is a collection of corpses that suffered briefly before expiring.”

Others wonder whether Canavero might simply be enjoying the limelight with a PR stunt, including Dr Arthur Caplan, director of ethics at the NYU Langone Medical Centre. Describing the doctor as “nuts,” he explained to CNN: “Their bodies would end up being overwhelmed with different pathways and chemistry than they’re used to, and they’d go crazy.”

“We’ll probably see a head on a robot before we see it on [another] body,” he told Live Science.

Dr John Adler of Stanford University’s school of medicine is slightly more optimistic… but not much more. “Conceptually, much of this could work, but the most favourable outcome will be little more than a Christopher Reeve level of function,” he told Newsweek.

Canavero is aware of this criticism, claiming that “silently” he’s received a “lot of support” from the medical community. Of Dr Batjer’s comments that the surgery would be a fate “worse than death”, Canavero is scathing. “He’s a vascular surgeon. A vascular surgeon of the brain, yes, but he knows nothing,” he argued. “How can you say such a thing? It’s incredible.”

“The world is moving, the critics are dwindling. Of course, there will always be critics. Science teaches us that when you propose something groundbreaking, you must be confronted by criticism. If no critics really step forward, you are saying nothing special,” he told Medical News Today.

Dr Canavero also believes that the operation could essentially be used to revive the dead, if brains were suitably frozen and stored. In an interview with German magazine Ooom, Canavero said: “We will try to bring the first of the company’s patients back to life, not in 100 years. As soon as the first human head transplant has taken place, i.e. no later than 2018, we will be able to attempt to reawaken the first frozen head. We are currently planning the world’s first brain transplant, and I consider it realistic that we will be ready in three years at the latest.”

Has a head transplant been tried before?

No-one has ever attempted a human head transplant before, and attempts on animals have – to put it charitably – had limited success.

Image: from Motherboard, uploaded under fair use from a 1959 issue of Life

The photo above really does show a dog with two heads – and it’s not a fake. This was the work of Soviet scientist Vladimir Demikhov, and for four days the hybrid of two dogs lived as normally as such a scientific horror could be expected to. Then they died.

Demikhov tried the experiment more than 24 times but was unable to find a way of preventing the dogs from dying shortly after surgery. Although the results are horrifying to see, Demikhov’s research did pave the way for human organ transplants.

But back to the topic of head transplants. The first time a straight swap was “successful”, was by Dr Robert White, in an experiment on a rhesus monkey in 1970. I feel the need to qualify the word “successful” with quotation marks, because although the monkey did live, he didn’t live very long. Eight days, to be exact, and as the spinal cord wasn’t attached to its new body, the monkey was paralysed for its remaining days. However, it could indeed see, hear, smell and taste before the body rejected the foreign head.

According to Canavero in his paper on human head transplants, “the monkey lived eight days and was, by all measures, normal, having suffered no complications.” However, Dr Jerry Silver – who worked in the same lab as Dr White – has more haunting memories. He told CBS: “I remember that the head would wake up, the facial expressions looked like terrible pain and confusion and anxiety in the animal. The head will stay alive, but not very long. It was just awful. I don’t think it should ever be done again.”

More recently, Chinese doctor Xiaoping Ren claims to have conducted head transplants on more than 1,000 mice. The Wall Street Journal reports having witnessed a mouse with a new head moving, breathing, looking around and drinking. But, crucially, none of these mice have lived longer than a few minutes.

Still, Dr Ren’s studies continue, and the latest reports are said to be “promising”, offering a possible answer to the risk of severe blood loss (or brain ischemia) during transplantation. “The experimental method that we have described can allow for long-term survival, and thus assessment of transplant rejection and central nervous system recovery, bringing us one step closer to AHBR in man,” the researchers wrote.

Ren himself has not ruled out taking part in the first human head transplant operation, according to the Daily Mail. “A human head transplant will be a new frontier in science. Some people say it is the last frontier in medicine. It is a very sensitive and very controversial subject but if we can translate it to clinical practice, we can save a lot of lives,” he said. 

“Many people say a head transplant is not ethical. But what is the essence of a person? A person is the brain not the body. The body is just an organ,” he added.

In January 2016, Canavero told New Scientist that a head transplant had been successfully completed on a monkey in China, although details were sparse. “The monkey fully survived the procedure without any neurological injury of whatever kind,” he said, although the article notes that the monkey only kept alive for 20 hours after the surgery for “ethical reasons,” limiting its use as a comparison somewhat.

In September 2016, Canavero revealed a further trial of the head transplant on dogs. New Scientist has seen video footage of a dog appearing to walk three weeks after its spinal cord was severed, with Canavero claiming that the outcome is the result of the same techniques he plans to use on Spiridonov next year. 

However, speaking to a number of scientists for their view on the new evidence, New Scientist could find few sceptics converted. “These papers do not support moving forward in humans,” said Jerry Silver a neuroscientist at Cape Western Reserve University in Ohio.

“The dog is a case report, and you can’t learn very much from a single animal without controls. They claim they cut the cervical cord 90 per cent but there’s no evidence of that in the paper, just some crude pictures,” added Silver. 

In May 2017, Canavero claimed success with another animal model: rats. Canavero and his team of Chinese surgeons claimed they were able to transplant the head of a donor rat onto the back of a larger one, creating a two-headed animal. The creature’s donor head was allegedly able to blink and respond after the operation, although it only lived for 36 hours, which may not inspire confidence – even with rodents’ reduced lifespans.

Elsewhere, news comes from the journal CNS Neuroscience and Therapeutics, where Xiaping Ren from the Harbin Medical University claims to have successfully repaired severed spinal cords in rats using the same principals that Dr Canavero wants to use on humans before the year is out.

Nine rats were treated with polyethylene glycol (PEG). Eight were still alive a month after the operation, and by day 28 they had regained the ability to walk – two were described as being “basically normal”.

Canavero told Newsweek that this showed his critics were wrong: “Critics said the transected spinal cord is unrecoverable and thus a human head transplant is impossible…The scans show the reconstructed cord. No pain syndrome emerged over the duration of the study, again rebutting a critic’s ‘worse than death’ remark.”

Time will tell – the team plans to move onto dogs next. It should be noted, however, that even if this is right and even if it is applicable to humans, this relates to repairing severed spinal cords – not attaching a new head. If the research is accurate, it is indeed a point for Canavero and his proposed methods – but we’re a long way from it being anything close to the finished article.

So a successful human head transplant would be quite the medical breakthrough then?

You could say so, though Canavero doesn’t see it quite like that. In fact, controversially he sees it more as a failure of other types of medicine, telling Medical News Today, “It will be about curing incurable neurological disorders for which other treatments have failed big time, so gene therapy, stem cells – they all just came to nothing. We have failed despite billions of dollars being poured into this sort of research.”

“So actually, head transplant or body transplant, whatever your angle is, is actually a failure of medicine. It is not a brilliant success, a brilliant advancement to medical science. When you just haven’t tackled biology, you don’t know how to treat genes, you don’t really understand, and you really need to resort to a body transplant, it means that you’ve failed. So this must not be construed as a success of medical research,” he added.

Wait, I’m sure I read about a human head transplant in South Africa?

You may well have done, but it was a hoax.

News Examiner carried a story stating that Paul Horner – an American with terminal bone cancer – had his head swapped out in a 19-hour operation at Charlotte Maxeke Johannesburg Hospital.

News Examiner is a hoax site, as described by the Washington Post here, but that didn’t stop some gullible (or cynical) sites picking up the story and making it spread.

Why are we so sure it’s fiction?

1. No reputable news sources have covered the story

2. The Charlotte Maxeke Johannesburg Hospital (which is real) never announced the groundbreaking procedure. You’d think they’d publish it somewhere

3. The picture used in the article comes from a legitimate article about the world’s first successful penis transplant

4. The quote allegedly given to CNN isn’t on their site, nor is any mention of the story

5. The alleged patient’s name is the same as the hoax site’s editor

Seriously, it hasn’t happened before – not in South Africa or anywhere else.

What are the challenges involved in a head transplant?

There are a few. Plenty of variables could go wrong individually, adding up to a veritable marathon of hurdles. Here are the principal problems, but others will be touched upon elsewhere:

1. The surgery requires the brain to be chilled to 12-15˚C, and not all brains can survive that. Dr Christopher Winfree, assistant professor of neurological surgery at Columbia University, told BuzzFeed: “If they do this on ten patients, only three to four might survive.”
2. Fusing a spinal cord has never been done before, and may not be possible. This is probably the main objection people have – this hasn’t even been attempted on animals, and it sounds hugely unlikely that millions of nerves will be able to connect perfectly as Canavero describes.
3. The transplant could be rejected. Immune system rejection occurs when the body sees a new part as foreign and attacks it – there’s a reason all the animals in these experiments died so quickly, and many place the blame at organ rejection. With an entire head, there are more organs to be rejected. Although the technology has come on a long way since then, some believe the quantity of anti-rejection medication required would poison the body.

What are the possible side effects of a human head transplant?

If the surgery goes ahead as planned – and that’s a big if – the most pressing risk is that the body will reject the head and the person will die. Of all the animals this kind of thing has been tried on – monkeys, mice and dogs – the longest any has lived is eight days. Canavero argues that his methodology is different, but he’s been pretty vague on the details.

Writing for Forbes, NYU’s Dr Arthur Caplan put this matter-of-factly: “I think the most likely result is insanity or severe mental disability.”

The proposed surgery involves putting the body into a coma for a month, which would bring its own risks such as blood clots, infection and reduced brain activity.

Who would volunteer for a human head transplant?

As it turns out, Canavero has already found a subject.

In fact, in an interview with Motherboard he claimed to have “folders replete with people willing to have the surgery,” but his chosen first subject was initially to be 30-year-old Russian computer scientist Valery Spiridonov. Spiridonov has Werdnig-Hoffman disease – a muscle-wasting condition.

Speaking to MailOnline, Spiridonov explained that, although he’s terrified of being the first human subject and the high chance of repercussions, he doesn’t feel he has much choice. “If I don’t try this chance, my fate will be very sad. With every year my state is getting worse,” he explained.

“I can hardly control my body now. I need help every day, every minute. I am now 30 years old, although people rarely live to more than 20 with this disease.”

“First of all, I am a scientist, I am an engineer, and I am keen to persuade people – medical professionals – that such an operation is necessary. I am not going crazy here and rushing to cut off my head, believe me. The surgery will take place only when all believe that success is 99% possible.”

Of Spiridonov, Canavero has nothing but praise, calling him an “incredible guy” and telling Motherboard, “he’s one hell of a hero, he’s one hell of a ballsy guy. He’s got guts beyond imagination.”

In August 2015, Spiridonov confirmed that private donors had approached him to ensure the surgery goes ahead. “He [Canavero] received several offers, mainly those were people who contacted him through me, because I’m widely-known on the internet.”

However in 2017, once the venue for the surgery was confirmed to be in China, Canavero announced that the surgery would instead be performed on a Chinese patient. Spiridonov told The Daily Mail that he would be crowdfunding for a more conventional treatment instead, and described the news that he would not be the first subject after all as “a weight lifted off my chest.”

How much would a human head transplant cost… and who foots the bill?

Well that’s (yet another area) where it gets tricky. As you might expect, a head transplant is not a quick procedure. Canavero is estimating the procedure would require 150 doctors and nurses over 36 hours, at a cost of more than £9 million.

Despite recent reports suggesting that private donors have raised as much as £64 million to fund the debut surgery, that doesn’t appear to be the case as Spiridonov began efforts to crowdfund the money required for his possibly fatal procedure, before dropping out. The Daily Mail reports that Spiridonov opened an online shop selling souvenirs commemorating his big day, all emblazoned with the slogan ‘desire for life’. The shop is in Russian at the moment, but an English translation is coming soon, apparently, so Brits can get their hands on mugs, T-shirts, clocks and caps.

With prices starting at around £5 for a baseball cap, he’s likely to be saving for a while.

When and where will the first human head transplant take place?

In September 2015, reports suggested that the first human head transplant would take place at the Harbin Medical University in China, before the end of December 2017. China is rumoured to have been chosen for a couple of reasons:

1. It allows collaboration with Ren Xiaoping, the doctor who has performed over 1,000 head transplants on mice, as described earlier.

2. China has more relaxed regulations about what can and cannot be done in terms of medical research. Canavero is aware that conducting the surgery in certain countries could lead to a prison sentence, but The Independent reports he has been “studying Chinese for a few years.”

“A lot of media have been saying we will definitely attempt the surgery by 2017, but that’s only if every step before that proceeds smoothly,” Ren told AFP.

And what about the ethics of a human head transplant?

Given all the practical concerns above, the potential ethical issues of a human head transplant have taken something of a back seat, but there are some definite concerns. The most pressing of these is whether transplanting a whole body to save a single life at great expense is the best use of a cadaver full of smaller organs ripe for transplant.

There’s also the thorny philosophical issue of self – if your head is on another body, will it ever really be you? As Caplan said to LiveScience: “The idea behind this [transplant] is to preserve you, but if the only way you could do it is to transform your body, you haven’t really saved yourself – you’ve become someone else.”

As the first head transplant now looks set to take place in China, many have raised concerns that the donor bodies will be provided by recently executed criminals. As The Independent explains, in the past “China has been criticised for using the organs of executed prisoners without their consent.”

Religious leaders have also had something to say on the subject, with the Russian Orthodox Church warning prospective patient Spiridonov that he would be blending souls and “going against God”.

With regards to the ethics of the procedure, Canavero believes that the potential to fix severe medical conditions and alleviate suffering is the ultimate answer to any ethical question. He told Motherboard, “that is my answer to the ethical problem for the treatment of horrible medical conditions. If you want to know why we do this, go to any hospital and find someone with diseases like his. You’ll see what they do. You’re in a wheelchair for 24 hours, when you poo, you need someone to put away the doo, when you pee, you need someone to put away the pee, I’ll let you think about how it happens. Talk to anyone with these horrible conditions and you’ll know why we do it.”

Is the human head transplant a hoax?

Let’s take a break from the heavy-hitting ethical and physical barriers and ask a simple question that’s been dogging the internet for a few months: is this all a wind-up to promote a game?

In April 2015, a NeoGaf thread appeared pointing out the startling similarities between Cavanero and the baddy scientist that appears in the trailer for Metal Gear Solid V: The Phantom Pain.

Image source: Imgur

All kinds of connections were found to bolster this conspiracy theory, some (the similarity of a logo at his TED talk) more convincing than others (that Canavero has written papers on phantom pain). The video below highlights some of the evidence people claim to have found.

If Cavanero were wrapped up in a hoax, it would be an incredibly thorough one: as games website Kotaku notes, he’s published more than 100 papers. For his own part, Cavanero has signalled his intention to sue developers Konami over the similarities.

In September 2015, Metal Gear Solid V: The Phantom Pain was released, and Cavanero is still making plans. No, it’s not a PR stunt.

Head transplant Q&A

• Why bother with the whole head, when you could just swap the brains?

Although neither are exactly trivial operations, swapping brains between skulls is arguably even more complex than switching heads. Separating the brain from the blood supply makes damaging brain tissue more of a risk.

• Would a head transplant pass scientific and ethical regulations?

That depends on where in the world it was undertaken. In the US and the UK, this kind of surgery would likely be met with fierce resistance, but there are parts of the world where regulation is much more slack. It has been announced that the transplant will likely take place in China, raising the spectre of using criminals’ bodies as unwilling donors, given the country practices capital punishment on a broad scale.

As Dr Jaimie Shores, a hand surgeon from Johns Hopkins University, told Popular Science: “There are countries with much less regulation and oversight than here in the US where people have done some very controversial transplants that have resulted in the death of the patient.”

• Can I donate my body for a transplant?

Given that a human head transplant hasn’t yet been attempted, there are currently no clear rules for body donation, and regulations will vary country by country. New Scientist asked the question, and an NHS spokesperson gave an ambiguous response: “If a person needs something not specified on our forms, we would ask a potential donor’s family to consent. We would only approach a family if the planned procedure had ethical approval.”

We will continue to update this page as more developments occur. Stay tuned!

In other groundbreaking surgery news, dead hearts have been revived for use in transplants…

Image: Phalinn Ooi, Nixo Paix used under Creative Commons