Human head transplants’ gory, Frankenstein-esque history

At Mary Shelley’s FrankensteinA mad scientist creates a monstrous creature with severed body parts. In some film adaptations, a dismembered head is tacked onto the malformed body. Then, with the help of a storm, new life is born.

Since the first successful kidney transplant in 1954, modern organ transplantation has often been associated with the horrors of Frankenstein. While people now accept kidney and liver transplants as life-saving surgeries, the notion of head transplants still sparks Frankenstein-like revulsion in the medical community and beyond.

In 2015, Italian neurosurgeon Sergio Canavero was criticized for his plan to perform the first human head transplant on a volunteer patient with severe muscle atrophy, with the aim of restoring mobility.

Canavero planned to cut off the heads of the living patient and the body of a brain-dead donor, under extremely cold temperatures, and connect the patient’s dismembered head and brain to the donor’s body, first joining the head-body arteries to recirculate blood flow to the patient’s brain, then tackling the neck and spine connections.

Although Canavero’s patient ultimately backed out of the planned surgery, the surgeon’s claims sparked a debate over the validity of head transplants: Is it possible to remove and transfer human heads along with their brains? And if it is possible, is it ethical?

For Arthur Kaplan, renowned bioethicist and professor at the Grossman School of Medicine at New York University, the procedure would be neither ethical nor possible.

The ethics and logistics of human head transplants

The term head transplant refers to the experimental transfer of the brain, along with the skull, face, and parts of the neck and spine, to another body. Today, scientists consider head transplants to be theoretically more feasible than the extraction and transfer of isolated brains, due to the brain’s complex neuronal connections.

Kaplan tells Popular science that head transplants are impossible for many reasons: primarily, there is no medical procedure to fuse spinal cords, and while that is true, transplanting a patient’s head onto another human body is out of the question. Any head transplant recipient, without proper fusion of the spinal cord, would likely be paralyzed.

Ethically, Kaplan says, he presumes that the head transplant recipient would be overwhelmed and potentially disturbed by an influx of memories and visual, auditory and sensory pathways from the new body.

“Moving a head to another body gives this false idea that our personal identity resides entirely in our head,” Kaplan explains. “But we are, in fact, brains that circulate in our bodies and fill us with information. The idea is cool for science fiction or comics.”

“Physiologically, your brain is deeply embedded in a perceptual system,” he says. “If you change the location of the brain and put it somewhere else, whether it’s a robot or a new body, you have to redo all the inputs.”

Kaplan and Canavero are part of a growing conversation about the scope of medicine. For many medical professionals, the concept of transferring a human brain into a new body represents an uncomfortable boundary: between keeping patients healthy and using science to redefine human mortality. But how did we get here in modern medicine?

The first attempts at head transplantation

Since the beginning of the 20th century, the concept of experimental head transplantation has attracted public and scientific interest.

In 1908, French surgeon Alexis Carrel and American physiologist Charles Guthrie performed what is often described as the first documented canine head transplant. In their experiment, the two scientists attached a severed dog head to the body of another dog, thereby connecting the arteries and preserving blood flow. The dog retained its involuntary visual and muscular reflexes after the procedure, but its condition rapidly deteriorated and it was euthanized within hours.

Nearly fifty years later, Soviet scientist and surgeon Vladimir Demikhov made another attempt at canine head transplantation, grafting the head of a small dog onto the body of a donor dog to create a two-headed creature. Among several dogs, one lived nearly a month, although most died within days, their bodies rejecting the transplanted heads.

Demikhov’s experiment was more successful than Guthrie and Carrel’s, but it also faced heavy criticism. Demikhov, who had left a small Russian village to study, ultimately died largely unknown and in relative poverty.

In the 1950s and 1960s, advances in immunosuppressants marked a new chapter in the field of organ transplantation. These medications helped prevent outright rejection of the graft. In 1954, doctors successfully transplanted the first human kidney, followed by liver, heart and pancreas transplants in the late 1960s.

Immunosuppressants have also opened the door to more viable attempts at head transplants, although this experimentation has come at the cost of what some have called unnecessary, even cruel, sacrifices.

The lives of animals come at the expense of progress

Robert White, an American neurosurgeon, built his reputation studying the impacts of hypothermia on the central nervous system at Case Western Reserve University in Cleveland. White studied groups of rhesus monkeys under hypothermic conditions, documenting their memory and cognitive functions.

During a trip to the Soviet Union, White met Demikhov and was inspired by his work on dog head transplantation.

In 1970, White performed one of the best-known primate head transplant experiments – a step closer to human head transplants. His experiments consisted of attaching the heads of several rhesus monkeys to the bodies of the same species. White used his previous work on hypothermia to preserve brains in extreme cold during transplantation.

Several of White’s monkeys survived: after the operation, they could still see, bite and eat, but they were paralyzed from the neck down because their spinal columns could not be fused. The longest-surviving monkey lived for nine days, flooded with high levels of immunosuppressants that experts believe may have contributed to its eventual death.

White’s experiments sparked a wave of condemnation from animal rights activists. In 1995, an activist with People for the Ethical Treatment of Animals (PETA) wrote a letter to the editor published in The New York Timescalling the experiences “unspeakably cruel.”

However, White, who was a deeply religious man, was an advocate of animal experimentation in the name of human progress – he reportedly once asked, “Would you deny me a rat to cure cancer?”

New technologies that are transforming head transplants

Today, the legacy of these scientists, often operating on the fringes of academia, lives on in researchers like Canavero and his colleague, Chinese surgeon Xiaoping Ren.

In 2017, Ren and Canavero reported what they called the first documented cadaveric human head transplantation procedure, performed using two human cadavers.

The experiment did not attempt to fuse spinal cords, because both bodies had died: it aimed to show that human head transplantation was surgically possible by dissecting and attaching the severed head to the donor’s body.

A year later, the two scientists published a study attempting to address spinal cord fusion, the main obstacle to successful living human head transplants. The team severed the spinal cord in 12 dogs, then applied polyethylene glycol to the cut and applied an electric shock, reporting limited signs of motor recovery in some dogs.

Canavero and Ren have largely faded from the spotlight in recent times, but their drive for limitless medical advancement echoes the ambitions of tech founders like Elon Musk, who created Neuralink, a company that designs implantable brain-computer interfaces to help treat brain diseases. Musk has been the subject of federal investigations into the deaths of several primates used in Neuralink research.

The renewed interest in brain experimentation, such as brain transplants and neural chips, may be part of a growing trend to use technology to enhance humanity. Kaplan says it’s a symptom of the culture in certain circles.

“It’s in billionaire culture,” Kaplan says. “It’s in dweeb culture. It’s in body hacking culture. This type of thinking is a little more advanced in ‘brotech culture’ – that technology can solve all our woes.”

Whatever the topic of conversation, we can be sure that we have not heard the last of human head and brain transplantation.

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