Jojy Cheriyan MD,MPH---February 28,2015

"Sounds weird! Sounds Stupid! Sounds nonsense!" These have been the comments in some social media sites and sites of medical organizations. Some television channels showed it as a headline. Some neurosurgeons pooh-poohed the idea and called it impossible, but some say chances cannot be ruled out based on the successful experiments of head transplants done in mice and monkeys. The first successful monkey head transplant --i.e., moving the head of one monkey on to another --was carried out in 1970 at the Case Western Reserve University in Cleveland , U.S. They didn't join the spinal cord, so the monkey couldn't move, but, it was able to breathe with artificial assistance. The monkey could live only for nine days because its immune system rejected the head.

Sergio Canavero, a surgeon and medical scientist from Turin Neuromodulation Group, wants to perform this surgery in 2 years. The purpose is to extend the lives of people who are suffering from degenerative diseases of the muscles and nerves, and also those who suffer from brain cancers.

Dr.Canavero published a paper this month in the journal Surgical Neurology International . In an interview to the New Scientist he said “the major hurdles, such as fusing the spinal cord and preventing the body's immune system from rejecting the head, are surmountable, and the surgery could be ready as early as 2017.”

He said he plans to announce the project at the American Academy of Neurological and Orthopedic Surgeons (AANOS) conference, at Annapolis , Maryland, in June 2015.He first proposed the idea of head transplant in 2013. But fusing the spinal cord was the major concern.

In his new paper he discusses the fusion of spinal cord that was successfully done in animals.

The recipient's head and the donor's body would be cooled at the start of the procedure to extend the time that cells can survive without oxygen. Tissue around the neck would be dissected and major blood vessels would be joined using tiny tubes.

The spinal cords would then be cut and the recipient's head surgically sutured to the donor body. The ends of the spinal cord would be fused together using a chemical called polyethylene glycol, which encourages fat within cell membranes to mesh. This has been found to be successful in some experiments.

After this, the patient would be put into a coma for around four weeks to prevent him or her from moving while the healing process occur. Dr.Canavero said he would expect the patient to be able to move and feel his or her face. After waking up, he or she would speak with the same voice and should be able to walk within a year.

The project presents both philosophical and bioethical conundrums. Where would the bodies come from? Deceased donors? Euthanased donors? Altruistic donors? Of course, it might be hard to negotiate laws which assume that a decapitated person is a dead person. But Dr.Canavero is optimistic. According to his supporters, every advance in transplantation seemed outlandish at first, from hearts to hands to faces, but in each case, doubts have given way to appreciation.

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