A short history of radical transplants

An Italian surgeon pioneering total head transplants is giving us identity issues

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"We realised that evening, that we had done something monumental," explains Dr. Robert White, the first man to complete a head transplant on a monkey in 1970. "Either for good or bad, I realised that what I had done for the monkey, we could do for humans." Despite the efforts of 18 surgeons, biochemists and technicians over the course of a gruelling six hour surgery, the ape was paralysed from the waist down and died only eight days later. The failure to successfully reanimate the body was attributed to an inability to reconnect the spinal cord, yet a recently published paper from Italian neuroscientist Dr. Sergio Canavero suggests this may no longer be an issue. 

According to the world of fiction, science facilitates some true medical marvels: look no further than the automated surgery booth from Prometheus, the black market eye transplants of Minority Report or the reanimation of Frankenstein's monster in Mary Shelley's classic. Yet give science fiction a few decades to ferment, and it has a tendency to become science fact. 

Frankenstein underwent its Hollywood reimagining in 1931, and audiences the world over gasped in all the right places, grateful such a monstrosity would never grace the planes of reality. Yet within two years, Ukrainian surgeon Yurii Voronoy attempted the first ever organ transplant taken from a cadaver. In the '30s, tissue rejection was the largest risk for patients, but new developments in the '70s removed this issue, propelling organ transplants to the forefront of medical innovation. 

Dr. White's procedure in 1970 was considered by many a turning point in modern medicine, yet the incomplete nature of the experiment allowed it to fall into the sprawling archives of medical history, dredged up as a reference point in light of recent developments. Earlier this year, after decades of work with nerve regeneration, neuroscientist Jerry Silver—who worked with White on the original head transplant, and has spoken publically of his horror at the procedure—successfully reconnected neurons in rats that had their spinal columns severed, completely restoring bladder control. 

Ironically, the work of the neuroscientist who condemned head transplants as "bad science" is part of the emerging research, which spurred Italian neuroscientist Dr Canavero to pursue this procedure. "The greatest technical hurdle to such endeavour is of course the reconnection of the donor's and recipient's spinal cords," reads his paper, which was published on Surgical Neurology International. "It is my contention that the technology only now exists for such linkage." The paper proceeds to outline the process at length, complete with gruesome diagrams. Beneath the somewhat unfitting acronym of HEAVEN (Head Anastomosis Venture), Canavero is set on using a combination of membrane-fusion substances, an ideally bespoke operating room and probably a little trial and error to transform the operation into a legitimate and commonplace procedure. 

"When we transplant the brain, do we transplant the soul?" A question posed to Pope Jean Paul II by Dr. White after the completion of his own procedure, the controversial neurosurgeon only scratches the surface of an overwhelming number of ethical concerns. Dr Stephen Rose of the Open University referred to the concept at "grotesque," noting that essentially the procedure simply "keeps a severed head alive in terms of circulation from another animal." Furthermore, the procedure—broadly discussed as a head transplant—would more accurately be described as a body transplant, since the 'self' exists within the brain. Cue imminent identity issues, pulling the patient straight from the operating table and into the psychiatrist's office.

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