If You Give a Man an Arm, He'll Ask You for an Entire Body

Medicine is doing more than making strides these days. Science is becoming increasingly advanced to the point where curing the blind and bringing people back from the dead are no longer Godly miracles, but targets of many ambitious scientists’ endeavors.

Neuroscience research has accelerated its medical advancements in the last decade or so at a much faster rate than in the last century. We have gone from prosthetics made from wooden shanks and sockets and steel knee joints in the 19th century to a lighter, patient-molded prosthetic that has more functionality. In this day and age, we have more realistic prosthetics, and the research has developed into using our own nerves to fully control these prosthetics, as we would with our own limbs.

(A) Targeted muscle reinnervation. The muscles that moved the arm
and were transferred to separate segments of the pectoralis major muscle.
(B) Targeted sensory reinnervation.  The sensory nerves were cut and
attached to the median nerve to send signals back to the brain.

In the journal, "Targeted innervation for enhanced prosthetic arm function in a woman with a proximal amputation: a case study," Dr. Gregory Dumanian and his team have studied the success of cutting and reconnecting neurons in amputees in order for the patient to gain functionality and sensory feedback in order to give an easier use of their prosthetics to live a normal life. In an amputee, their nerves from the brain are still fully functional even when cut. Therefore, doctors like Dumanian can cut and reconnect those nerves to a part of the body where the prosthetic can attach to in order to move the prosthetic in similar ways to moving their own limb.

There is no denying that there is a great need for neural-machine interfaces, like these neurally connected prosthetic limbs, that can help amputees, or those who suffer from paralysis or stroke, to interact more productively with their environment. There is a great need to improve the lives of these patients in terms of functionality and the research is becoming increasingly clearer, as seen through the work of Dr. Dumanian. But what justifies the leap between a neurally regulated prosthetic to giving one of these patients a completely new body?

Map of areas that the patient perceived as
              distinctly different fingers in response to touch

A normal response to this may be, "Well you're comparing apples to oranges. There's no way we can put someone's head on a completely different body." And normally, they would be right. However, Professor Sergio Canavero set this as his mission, and this December 2017, he plans on performing the first ever head transplant.

We just went from taking decades to go from a plastic prosthetic to a neurally regulated prosthetic, and now it's only been a few years to go from that to completely cutting all nerves and spinal cord and putting it on someone else's body. 

As Canavero stated in Newsbeat, "It's not a decade, it's not years and I expect to have everything ready to roll by the end of 2017." Canavero's ambitious nature has influenced 150 other medical staff to commit to 36 hours of operation alongside him. But who would be the lucky participant in this history making surgery?

Valery Spiridonov is a 31 year old wheelchair bound man who suffers from Werdnig-Hoffman's disease, a disease that wastes away the motor neurons in his spinal cord, destroying his muscles and taking nearly all of his functionality. He would be taking a donor's body while keeping his own head.

"But, like, how?"

Nearly everyone keeps asking this question. Canavero has assured that this surgery is completely possible to perform with a 90% chance of success, meaning that the patient will wake up after surgery without any complications and begin walking in a month with physiotherapy. That's a pretty high chance of success given that we have never tried anything as extensive as this surgery. Canavero says that the surgery will entail freezing the head and body to prevent cell death, followed by cutting the neck and fitting the arteries and veins in tubes so they may remain intact. The tricky part is cutting and reattaching the spinal cord of the new donor body. If this is done successfully, then the muscles, organs, and skins will be attached together. 

Valery Spiridonov, 31

It all seems very "clear cut" when it's on paper and in a lab, but something that Canavero and his doctors need to also be aware of is the strong possibility of the patient developing symptomatic neuromas. These neuromas are caused by the nerves not lining up correctly when it is becoming reattached. This causes a buildup of sensation that can be extremely painful for the patient. Another major concern is death. I mean, that should be the number one priority when someone's head gets chopped off. All joking aside, the slightest error during surgery could be fatal.

We must, therefore, address the ethical issue of people going too far. If this is a success, in years to come, people may be opting to trade their body for a donor body that can give them an unequal advantage at life. This “quick fix” may limit how much effort science will put into looking for cures for these disorders. A shift in medicine can occur in which people will no longer focus on what we should do and steer towards what we can do. Another concern is the limited availability of donors that already exists. Taking an entire donor body for one person is much more costly than to distribute the organs to multiple people in order to save more lives than just the one.

References

Brown, Lindsay. "The Surgeon Who Wants to Perform a Head Transplant by 2017 - BBC Newsbeat." BBC News. BBC, 20 Sept. 2016. Web. 03 Apr. 2017.

Kuiken, Todd A., Laura A. Miller, Robert D. Lipschutz, Blair A. Lock, Kathy Stubblefield, Paul D. Marasco, Ping Zhou, and Gregory A. Dumanian. "Targeted Reinnervation for Enhanced Prosthetic Arm Function in a Woman with a Proximal Amputation: A Case Study." The Lancet 369.9559 (2007): 371-80. Web.

Norton, Kim M. "Amputee Coalition." Resources and News for Amputees, Amputation, Limb Loss, Caregivers and Healthcare Providers. Amputee Coalition, n.d. Web. 04 Apr. 2017