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

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