Human head transplantation. Where do we stand and a call to arms

The Facial Graft: A Graft of Emotions? (About the Reanimation of the Facial Allotransplantation)

Although there have been numerous scientific papers reporting on composite allotransplantation of the face, few have been about assessment and evolution of the functional benefit for patients in terms of soft tissue mobility, movement coordination, and face expressions, even fewer on the choice of the surgical procedures to restore motricity. On some videos and interviews, it is possible to analyze significative motricity. Of course that has been voluntary motricity, not emotional motricity. The data confirmed that the result on the complexity of the expression of the face is not great, providing opportunity to reflect on the question of nerve regeneration.

What Happens if the Brain Goes Elsewhere? Reflections on Head Transplantation and Personal Embodiment

Brain transplants have long been no more than the subject of science fiction and engaging thought experiments. That is no longer true. Neuroscientists have announced their intention to transplant the head of a volunteer onto a donated body. Response has been decidedly mixed. How should we think about the moral permissibility of head transplants? Is it a life-saving/life-enhancing opportunity that appropriately expands the boundaries of medical practice? Or, is it a bioethical morass that ought not to be attempted? For the purposes of this paper, I set aside questions regarding the surgical operation's technological plausibility so as to focus on very basic questions regarding personal identity and the morality of head transplantation. The analysis begins with an exploration of the embodiment of persons. It considers whether persons can be conceptually distinguished from all parts of their body, even if they cannot be physically separated from some parts without loss of personhood. It argues that in most cases replacing body parts with reasonably similar parts will not destroy the conditions for sustaining personhood. However, as I explore, the phenomenology of personhood is such that some physical changes may prove to be too significant to maintain personal identity successfully over time. Given such complexity and the significance of the costs involved, the moral permissibility of head transplantation likely depends on recognizing that persons may give permission to collaborate in common activities, including projects with which others deeply disagree, provided that they only utilize the services and resources of free and consenting others.

Whole-Body/Head Transplantation: Personal Identity, Experimental Surgery, and Bioethics

This issue of The Journal of Medicine and Philosophy brings together an international group of scholars from Hong Kong, Mainland China, and North America, critically to explore whole-body/head transplantation. The proposed procedure raises significant philosophical, ethical, and social/political questions. For example, assuming transplant is successful, who survives the surgery? Does personal identity necessarily follow the head? The contributors to this special thematic issue explore the nature and ground of personal identity, what it would mean to preserve personal identity, given such a significant set of physical changes, as well as the morality of such a procedure. As the authors make clear, careful conceptual philosophical analysis is essential for understanding whether whole-body/head transplantation is a life-saving/life-enhancing technological innovation, or a bioethical morass that should not be attempted. How we come to terms with such conceptual and moral concerns will have a significant impact on the future of medicine and medical technological innovation.

First Human Head Transplantation: Surgically Challenging, Ethically Controversial and Historically Tempting – an Experimental Endeavor or a Scientific Landmark?

According to many, head transplantation is considered to be an extraordinary and impossible surgical procedure. However, nowadays, relevant literature and recent advances suggest that the first human head transplantation might be feasible. This innovative surgery promises a life-saving procedure to individuals who suffer from a terminal disease, but whose head and brain are healthy. Recently, the first cephalosomatic anastomosis in a human model was successfully performed, confirming the surgical feasibility of the procedure, but still not the real outcome. Skepticism and several considerations, including surgical, ethical and psychosocial issues, have emerged in the scientific community since this imaginary procedure seems to be more feasible than ever before.

PROJECT HEAVEN: Preoperative Training in Virtual Reality

A cephalosomatic anastomosis (CSA; also called HEAVEN: head anastomosis venture) has been proposed as an option for patients with neurological impairments, such as spinal cord injury (SCI), and terminal medical illnesses, for which medicine is currently powerless. Protocols to prepare a patient for life after CSA do not currently exist. However, methods used in conventional neurorehabilitation can be used as a reference for developing preparatory training. Studies on virtual reality (VR) technologies have documented VR's ability to enhance rehabilitation and improve the quality of recovery in patients with neurological disabilities. VR-augmented rehabilitation resulted in increased motivation towards performing functional training and improved the biopsychosocial state of patients. In addition, VR experiences coupled with haptic feedback promote neuroplasticity, resulting in the recovery of motor functions in neurologically-impaired individuals. To prepare the recipient psychologically for life after CSA, the development of VR experiences paired with haptic feedback is proposed. This proposal aims to innovate techniques in conventional neurorehabilitation to implement preoperative psychological training for the recipient of HEAVEN. Recipient's familiarity to body movements will prevent unexpected psychological reactions from occurring after the HEAVEN procedure.

A cross-circulated bicephalic model of head transplantation

AIMS

A successful cephalosomatic anastomosis ("head transplant") requires, among others, the ability to control long-term immune rejection and avoidance of ischemic events during the head transference phase. We developed a bicephalic model of head transplantation to study these aspects.

METHODS AND RESULTS

The thoracic aorta and superior vena cava of a donor rat were anastomosed with the carotid artery and extracorporeal veins of a recipient rat by vascular grafts. Before thoracotomy in the donor rat, the axillary artery and vein of the donor were connected to the carotid and the extracranial vein of the third rat through a silicone tube. The silicone tube was passed through a peristaltic pump to ensure donor brain tissue blood supply. There is no ischemia reperfusion injury in donor brain tissue analyzed by electroencephalogram. Postoperative donor has pain reflex and corneal reflex.

CONCLUSIONS

Peristaltic pump application can guarantee the blood supply of donor brain tissue per unit time, while the application of temperature change device to the silicone tube can protect the brain tissue hypothermia, postoperative experimental data show that there is no brain tissue ischemia during the whole operation. The application of vascular grafting can also provide the possibility of long-term survival of the model.