Head implant - the conquest of pioneering anatomists

In the laboratory in Harbin, Professor Xiaoping Ren stood up after 10 hours to bend over the operating table, proudly watching the black mouse with a new brown head.

Can a transplant be a reality in the future?

When he removes the ventilator from the mouse, the head begins to breathe, getting used to the new body. About a few hours later, he opened his eyes, recalled Dr. Ren.

The transplant performed in July 2013, since then, he and his colleagues at Harbin Medical University, north of China, have implanted nearly 1,000 mice , experimenting with different ways to help it live. longer.

The mouse that lived the longest after transplanting was a day. The transplanted details were published in the December 2014 international scientific journal CNS Neuroscience and Therapeutics.

Dr. Ren intends to try monkey head implants this summer, hoping to create the first grafted primates that can live and breathe on their own, even if only for a short time.

If successful, China will be the first technology breakthrough of this future. Since the mid-90s, the Chinese government has not been afraid to pour money into scientific research, especially those with high potential or breakthrough.

Investment in China's science and technology accounted for 10% of total global research and development spending in 2009, and increased to 18% this year, according to the Battelle Memorial Institute, a non-profit organization. about science and technology applications based in Ohio, USA.

"Now, China wants to top the world, " said Dr. Ren. "If you think that research is really great, China will support you."

One of China's main goals is to become a scientific power, recognized by the world."Leaders want to see Chinese people get Nobel prizes ," said Cong Cao, professor of contemporary Chinese studies, University of Nottingham, England.

"Creative, creative, creative," Chinese President Xi Jinping told the domestic scientific community last year, urging them to make a breakthrough in science, the key to bringing China to the future.

However, some Chinese studies have been controversial. A research team in Guangdong province caused a wave of global protests in April, when it announced the modification of a human embryonic gene , changing the patient's DNA to their children.

Western ethics and scientists call on China to stop editing genes. It is expected that next fall, the scientific community will hold an international conference, discussing the technology of editing controversial tree genes.

During this conference, it is likely that Dr. Ren's research will be very popular. Dr. Ren was from Harbin, studied and worked in the United States for more than 15 years before quitting her job as a lecturer at Cincinnati Medical University, returning home three years ago. Ren and his two daughters Ren are still in the US, every year, he visits them several times.

Ren spent most of her time in the laboratory in Harbin. He completed a 2013 mouse head transplant on a Saturday morning. Ren said that one of the reasons for water is the strong support of the Chinese government for medical research. In addition, Ren is not sure if he will be allowed to do research in the United States .

According to other researchers, early implant experiments in the US face many financial and moral obstacles. But at Harbin Medical University, where Doctor Ren took over the microsurgery center, he was given moral and absolute support. The government and the school funded him 10 million yuan, equivalent to 1.6 million USD as the subject.

Prospective head implant

Head implants are not frivolous, Ren said. If you complete the implant technique, one day it will help patients with intact brain, but the body is damaged such as spinal cord injury, cancer, muscle atrophy.

Dr. Ren does not want to speed up research. He also did not predict when a human head would be implanted.

"We want to do clinical trials, but we have to try on animals first, see how long they can live," he said, exuding agility and full of energy at age 53. "Right now, I'm not enough. confident to say can transplant human head. "

The prospect of head implants raises many philosophical and moral issues. How does that person's identity change, when there is a new body? Even if the transplant technique is complete, is it true or false for a person to have a healthy organ to donate to many others?

In addition, there are many doubts about the origin of donation body . In China, like many other countries, there is always a shortage of organ donations. Dr. Ren said, can find many different sources of donation, such as an accident.

Robert Truog, director of the Center for Biological Ethics, Harvard Medical School, said that although a head implant "has a close relationship with the person," there is no moral reason for not having an implant if approval committee approved. "I imagine that, for years to come, we will see something," Truog said. "And I imagine that it will happen everywhere."

According to Peter Singer, Princeton biology director, when presented with head implants, he said that it was not possible to experiment on primates at this stage because it was too vague.

Another expert said that the idea of ​​transplanting was too terrible.

"The whole idea is ridiculous," said Arthur Caplan, a biologist at New York University School of Medicine, who thinks it's not worth the sacrifice of animals to experiment.

New horizon of surgery

The idea of ​​a head implant has long. Since the beginning of the 20th century, CCGuthrie American scientist has tried to implant a dog head . After implantation, the head only appears unconscious reflexes. In the 1950s, the Russians, then the Chinese, also performed similar transplants. This time, the head can do simple things like drinking water.

The first grafted mouse can drink water.(Screenshot: WSJ)

Two decades later, Robert J. White, Case Westen Reserve professor, Ohio, USA, implanted a rhesus monkey head . The monkey looked around, trying to bite a researcher's hand, but could not breathe on his own.

With that transplant, Dr. White is called " Dr. Frankenstein" , the character in the famous fiction novel of writer Marry Shell, often publicized during Halloween, director of public relations George Stamatis, medical university where Dr. White works, said.

Most recently, an Italian neurosurgeon, Sergio Canavero , made an impression by declaring that he would perfect the head implant technique for two years, and found the patient ready for his head.

Dr. Ren said, Mr. Canavero asked him to cooperate with an animal test . Ren agreed, but Canavero refused to confirm.

Mr. Ren started thinking about the first transplant about a decade ago. As a surgeon, he always aspires to edit seemingly irreparable things. In 1996, he moved to the United States, attended a 5-year microsurgery training course at Louisville Medical University, joined the pioneering group in the field of hand grafting.

After that, he worked as a lecturer at the University of Cincinnati. For 10 years, he studied one of the biggest challenges of organ transplantation techniques, how to prevent ischemia, or lack of oxygen to transplant organs.

Finally, he began to think of "What is the next limit?" In the field of orthopedic surgery, it is a head implant.

" In America, people are shocked" with that idea, Dr. Ren recalls. He faced a storm of criticism by bioethics at the University of Louisville, as well as those who objected to hand transplants in the late 1990s, and face transplants.

Dr. Ren returned to China in 2012, although he remained an adjunct professor at Loyola University in Chicago. The school board said it was not related to his head transplant experiment.

In China, it is not only easier to apply for approval and to seek funding, it is also easier to obtain permission to experiment on animals. Dr. Ren believes he will be allowed to experiment on long-tailed monkeys , a small and friendly animal that lives near Suzhou, Jiangsu Province in southern China.

They need time to adapt to the cold climate in Harbin, the high mountains have an average temperature of -14 degrees Celsius in January. He predicted that he could call the local airport directly when the monkeys were transferred, and sent to the lab.

Dr. Ren in the laboratory in Harbin.(Screenshot: WSJ)

In Harbin, Dr. Ren is granted a large and modern laboratory, which brings together a team of neurosurgeons, cardiologists, spinal cord and immunologists. Initially, his colleagues rated his idea quite crazy, but gradually, they wanted to cooperate.

" This is a great challenge, but extremely interesting," one partner said. Outside of work, Dr. Ren enjoys gathering with students. They say, sometimes, he encourages them to study, even invite student beer.

The biggest challenge

In mouse-head transplants , even though the spinal cord and brain contain large amounts of nerves, Ren's group is testing only a small fraction, enough for the animal to breathe and do basic reflexes.

The two biggest hurdles are preventing immune elimination and keeping the brain alive when cut off , Dr. Ren said. Just 5 minutes without oxygen, the brain will be permanently damaged.

The first step of the surgery is to perform " trauma clean" (excluding lesions), using a cutting edge super sharp diamond blade for the first part. At the body part, the head is also cut, but cut in the middle of the brain, keeping the heart still beating the body.

Because the brain needs constant pumping of oxygen, Dr. Ren will temporarily connect blood vessels from the donor body with the beating heart to the end of the implant, using silicone tubes that connect one side of the head. Then, under the microscope, the anatomical group connects the spinal cord nerves to the new body, locking them with a polyethylene glycol compound. They hope this compound will boost instant nerves.

The operations must be very fast, the next step is to attach the spinal input, using pins, screws, plates. Finally, they use small sutures that connect the blood vessels of the other end to the body, then muscles and skin.

Dr. Ren intends, if implanted in monkeys, he only reconnects a very small part of the 100 billion spinal nerves. During this process, the wires will be electrified by electric detectors placed in the spinal cord at the head and body, to keep the nerves functioning properly.

Only 10-20% of the nerves are successfully connected, the body can retain basic functions such as muscle movement, the team predicted. However, they hope to gradually increase this rate. If successful, it will help with the process of applying for clinical trials on people.

Several other organ transplant specialists were confused when expressing their views on Dr. Ren's experiment. A former colleague of his at Louisville University, John H.Barker, rated Dr. Ren as a good surgeon, and suggested that a head transplant could be done.

Dr. Sergio Canavero claims to be able to transplant a human head in 2017, while many say that this is impossible.(Photo: Mirror)

From the perspective of immunology and ethics, head implants are like hand or face transplants, Dr. Baker said, currently working at Goethe University, Germany.

Peter, a specialist in hand transplant, University of Cincinnati orthopedic professor, who trained Dr. Ren, said that Chinese scientists are doing a "very interesting and potential. However, they will encountered many challenges such as moral issues, immunosuppression, because head implants require extremely complex techniques, especially the regeneration of nerves. "

Dr. Ren said that, for the rest of his life, he did not know when a head transplant would become a health care measure for human health. He hoped, at least, I could make a breakthrough progress, so that the next generation would have a development platform.

" Today is impossible, " he said. "But the future, that may come true."