• Animals
• Swine
• Spinal Cord Injuries/diagnostic imaging
• Spinal Cord Injuries/surgery
• Disease Models, Animal
• Thoracic Vertebrae/surgery
• Thoracic Vertebrae/diagnostic imaging
• Female
• Magnetic Resonance Imaging
• Plastic Surgery Procedures/methods
• Tomography, X-Ray Computed
• Recovery of Function
• Swine, Miniature
• Spinal Cord/diagnostic imaging
• Spinal Cord/surgery
• Spinal Cord/pathology

• Eye
• Immunological tolerance
• Nerve regeneration
• Optic nerve
• Transplantation

• Axon repair
• Chemical neuroprotection
• Neural conduction pathway
• Polyethylene glycol
• Spinal cord fusion
• Spinal cord injury

• Chitosan
• Fusogen-sealants
• Fusogens
• Neuro-PEG
• PEG-chitosan
• Polyethylene glycol
• Spinal cord injury

• PEG
• cell matrices
• chitosan
• neuro-PEG
• polyethylene glycol
• spinal cord injury
• spinal injury
• stem cells

• Animals
• Rabbits
• Chitosan/pharmacology
• Chitosan/therapeutic use
• Spinal Cord
• Spinal Cord Injuries/drug therapy
• Spinal Cord Injuries/pathology
• Polyethylene Glycols
• Recovery of Function

Clinical transplantology is a constantly evolving field of medicine. Kidney transplantation has become standard clinical practice, and it has a significant impact on reducing mortality and improving the quality of life of patients. Allogenic transplantation induces an immune response, which may lead to the rejection of the transplanted organ. The gold standard for evaluating rejection of the transplanted kidney by the recipient's organism is a biopsy of this organ. However, due to the high invasiveness of this procedure, alternative diagnostic methods are being sought. Therefore, the biomarkers may play an essential predictive role in transplant rejection. A review of the most promising biomarkers for early diagnosis and prognosis prediction of allogenic kidney transplant rejection summarizes novel data on neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), C-X-C motif chemokine 10 (CXCL-10), cystatin C (CysC), osteopontin (OPN), and clusterin (CLU) and analyses the dynamics of changes of the biomarkers mentioned above in kidney diseases and the mechanism of rejection of the transplanted kidney.

• family
• informed consent
• personal identity
• research ethics
• surgical innovation

• Confucian selfhood
• Confucianism
• body transplant
• head transplant
• head/whole body transplant
• human virtues
• personal identity
• self-cultivation

Glial scar formation impedes nerve regeneration/reinnervation after spinal cord injury (SCI); therefore, removal of scar tissue is essential for SCI treatment.

To investigate whether removing a spinal cord and transplanting a vascularized pedicle of hemisected spinal cord from the spinal cord caudal to the transection can restore motor function, to aid in the treatment of future clinical spinal cord injuries. We developed a canine model. After removal of a 1‐cm segment of the thoracic (T10–T11) spinal cord in eight beagles, a vascularized pedicle of hemisected spinal cord from the first 1.5 cm of the spinal cord caudal to the transection (cut along the posterior median sulcus of the spinal cord) was transplanted to bridge the transected spinal cord in the presence of a fusogen (polyethylene glycol, PEG) in four of the eight dogs. We used various forms of imaging, electron microscopy, and histologic data to determine that after our transplantation of a vascular pedicled hemisection to bridge the transected spinal cord, electrical continuity across the spinal bridge was restored.

Motor function was restored following our transplantation, as confirmed by the re‐establishment of anatomic continuity along with interfacial axonal sprouting.

Taken together, our findings suggest that SCI patients—who have previously been thought to have irreversible damage and/or paralysis—may be treated effectively with similar operative techniques to re‐establish electrical and functional continuity following SCI.

• GEMINI
• polyethylene glycol
• spinal cord
• spinal cord fusion
• spinal cord grafting
• spinal cord injury

• Brain
• Chick
• Embryo
• Recovery

• Electrical stimulation
• GEMINI
• polyethylene glycol
• spinal cord fusion
• spinal cord transection

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.

• Bioethics
• Body-to-head transplant (BHT)
• Global ethics
• HEAVEN
• Neuroethics
• Neurosurgery
• Transplant

• Bioethical Issues/legislation & jurisprudence
• Bioethics
• Head
• Humans
• Morals
• Transplants

• UL1 TR001409 NCATS NIH HHS
• Grant 720270 European Union's Horizon 2020 Research and Innovation Programme
• European Union’s Horizon 2020 Research and Innovation Programme
• AEHS Foundation Project Neuro-HOPE
• Austin and Ann O’Malley Distinguished Visiting Chair in Bioethics of Loyola Marymount University, CA

• Brain injury
• Brain perfusion
• Cephalosomatic anastomoses
• Head transplantation
• Hypothermia
• Robert White

A sharply transected spinal cord has been shown to be fused under the accelerating influence of membrane fusogens such as polyethylene glycol (PEG) (GEMINI protocol). Previous work provided evidence that this is in fact possible. Other fusogens might improve current results. In this study, we aimed to assess the effects of PEGylated graphene nanoribons (PEG-GNR, and called “TexasPEG” when prepared as 1wt% dispersion in PEG600) versus placebo (saline) on locomotor function recovery and cellular level in a rat model of spinal cord transection at lumbar segment 1 (L₁) level. In vivo and in vitro experiments (n = 10 per experiment) were designed. In the in vivo experiment, all rats were submitted to full spinal cord transection at L₁ level. Five weeks later, behavioral assessment was performed using the Basso Beattie Bresnahan (BBB) locomotor rating scale. Immunohistochemical staining with neuron marker neurofilament 200 (NF200) antibody and astrocytic scar marker glial fibrillary acidic protein (GFAP) was also performed in the injured spinal cord. In the in vitro experiment, the effects of TexasPEG application for 72 hours on the neurite outgrowth of SH-SY5Y cells were observed under the inverted microscope. Results of both in vivo and in vitro experiments suggest that TexasPEG reduces the formation of glial scars, promotes the regeneration of neurites, and thereby contributes to the recovery of locomotor function of a rat model of spinal cord transfection.

• GEMINI
• TexasPEG
• graphene nanoribbons
• nerve regeneration
• spinal cord fusion
• spinal cord transfection

Cephalosomatic anastomosis (CSA) has never been attempted before in man as the transected spinal cords of the body donor and body recipient could not be “fused” back together. Recent advances made this possible. Here, we report on the surgical steps necessary to reconnect a head to a body at the cervical level.

Full rehearsal of a CSA on two recently deceased human cadavers was performed at Harbin Medical University, Harbin, China.

The surgery took 18 hours to complete within the time frame planned for this surgery. Several advances resulted from this rehearsal, including optimization of the surgical steps, sparing of the main nerves (phrenics, recurrent laryngeal nerves), and assessment of vertebral stabilization.

Several specialties are involved in a full-scale CSA, including neck surgery, vascular surgery, orthopedic surgery, plastic surgery, gastrointestinal surgery, and neurosurgery, as well as the operating staff. This rehearsal confirmed the surgical feasibility of a human CSA and further validated the surgical plan. Education and coordination of all the operating teams and coordination of the operative staff was achieved in preparation for the live human CSA.

• Cephalosomatic anastomosis
• GEMINI
• head transplant
• spinal cord fusion
• spinal fixation
• vascular reconnection

• biomedical-community ethical consensus
• biomedical/biotechnological advances
• full-body transplants
• organ transplants
• procedures with insufficient science
• public responses to biomedical/biotechnological advances

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.

• GEMINI
• HEAVEN
• haptic feedback
• neurorehabilitation
• virtual reality

• Composite tissue allotransplantation
• Ethics
• Frontiers in surgery
• Head transplantation
• Vascularized composite allografts reconstructive transplant surgery

• Brain Tissue Transplantation/ethics
• Brain Tissue Transplantation/psychology
• Head/surgery
• Human Body
• Humans
• Organ Transplantation/ethics
• Organ Transplantation/psychology
• Transplantation, Homologous/ethics
• Transplantation, Homologous/psychology

• T32 HL007854 NHLBI NIH HHS

• head transplantation
• immune rejection
• ischemia reperfusion injury
• rat model

Since the turn of the last century, the prospect of head transplantation has captured the imagination of scientists and the general public. Recently, head transplant has regained attention in popular media, as neurosurgeons have proposed performing this procedure in 2017. Given the potential impact of such a procedure, we were interested in learning the history of the technical hurdles that need to be overcome, and determine if it is even technically possible to perform such a procedure on humans today.

We conducted a historical review of available literature on the technical challenges and developments of head transplantation. The many social, psychological, ethical, religious, cultural, and legal questions of head transplantation were beyond the scope of this review.

Our historical review identified the following important technical considerations related to performing a head transplant: maintenance of blood flow to an isolated brain via vessel anastomosis; availability of immunosuppressive agents; spinal anastomosis and fusion following cord transfection; pain control in the recipient. Several animal studies have demonstrated success in maintaining recipient cerebral perfusion and achieving immunosuppression. However, there is currently sparse evidence in favor of successful spinal anastomosis and fusion after transection. While recent publications by an Italian group offer novel approaches to this challenge, research on this topic has been sparse and hinges on procedures performed in animal models in the 1970s. How transferrable these older methods are to the human nervous system is unclear and warrants further exploration.

Our review identified several important considerations related to performing a viable head transplantation. Besides the technical challenges that remain, there are important ethical issues to consider, such as exploitation of vulnerable patients and informed consent. Thus, besides the remaining technical challenges, these ethical issues will also need to be addressed before moving these studies to the clinic.

• Brain transplant
• Cephalosomatic anastomosis
• Head transplantation
• Spinal cord fusion

The HEAVEN head transplant initiative needs human data concerning the acute restoration of motor transmission after application of fusogens to the severed cord in man. Data from two centuries ago prove that a fresh cadaver, after hanging or decapitation, can be mobilized by electrical stimulation for up to 3 hours. By administering spinal cord stimulation by applied paddles to the cord or transcranial magnetic stimulation to M1 and recording motor evoked potentials, it should be possible to test fusogens in fresh cadavers. Delayed neuronal death might be the neuropathological reason.

• Delayed neuronal death
• electrical stimulation
• fusogens
• spinal cord fusion

• Gemini
• head transplantation
• heaven
• peg
• spinal cord fusion

The GEMINI spinal cord fusion protocol has been developed to achieve a successful cephalosomatic anastomosis. Here, we report the preliminary data on the use of a fusogen [polyethylene glycol (PEG)] after full cervical cord transection in mice to facilitate the fusion of both ends of a sharply transected spinal cord.

Cervical laminectomy and a complete, visually confirmed cervical cord (C 5) transection was performed on female albino mice (n = 16). In Group 1 (n = 8), a fusogen, (PEG) was used to bridge the gap between the cut ends of the spinal cord. Group 2 received the same spinal cord transection but was treated with saline. Outcome was assessed daily using a standard scale (modified 22-point Basso-Beattie-Bresnahan scale) and filmed on camera.

The PEG group (group 1) showed partial restoration of motor function after 4 weeks of observation; group 2 (placebo) did not recover any useful motor activity.

In this preliminary experiment, PEG, but not saline, promoted partial motor recovery in mice submitted to full cervical transection.

• Cephalosomatic anastomosis
• GEMINI
• PEG
• spinal cord fusion

• Cephalosomatic anastomosis
• GEMINI
• electrophysiology
• graphene nanoribbons
• spinal cord fusion

A case report on observing the recovery of sensory-motor function after cervical spinal cord transection.

Laminectomy and transection of cervical spinal cord (C5) was performed on a male beagle weighing 3.5 kg. After applying polyethylene glycol (PEG) on the severed part, reconstruction of cervical spinal cord was confirmed by the restoration of sensorimotor function. Tetraplegia was observed immediately after operation, however, the dog showed stable respiration and survival without any complication. The dog showed fast recovery after 1 week, and recovered approximately 90% of normal sensorimotor function 3 weeks after the operation, although urinary disorder was still present. All recovery stages were recorded by video camera twice a week for behavioral analysis.

While current belief holds that functional recovery is impossible after a section greater than 50% at C5-6 in the canine model, this case study shows the possibility of cervical spinal cord reconstruction after near-total transection. Furthermore, this case study also confirms that PEG can truly expedite the recovery of sensorimotor function after cervical spinal cord sections in dogs.

• Cervical spinal cord transection
• dog
• polyethylene glycol
• sensorimotor function

• Central pain
• Cephalosomatic anastomosis
• Head transplant
• Neuropathic pain

• Bioethics
• neuroethical
• neuroethical issues
• neuroethics

In the past, philosophers, scientists, and even the general opinion, had no problem in accepting the existence of consciousness in the same way as the existence of the physical world. After the advent of Newtonian mechanics, science embraced a complete materialistic conception about reality. Scientists started proposing hypotheses like abiogenesis (origin of first life from accumulation of atoms and molecules) and the Big Bang theory (the explosion theory for explaining the origin of universe). How the universe came to be what it is now is a key philosophical question. The hypothesis that it came from Nothing (as proposed by Stephen Hawking, among others), proves to be dissembling, since the quantum vacuum can hardly be considered a void. In modern science, it is generally assumed that matter existed before the universe came to be. Modern science hypothesizes that the manifestation of life on Earth is nothing but a mere increment in the complexity of matter — and hence is an outcome of evolution of matter (chemical evolution) following the Big Bang. After the manifestation of life, modern science believed that chemical evolution transformed itself into biological evolution, which then had caused the entire biodiversity on our planet. The ontological view of the organism as a complex machine presumes life as just a chance occurrence, without any inner purpose. This approach in science leaves no room for the subjective aspect of consciousness in its attempt to know the world as the relationships among forces, atoms, and molecules. On the other hand, the Vedāntic view states that the origin of everything material and nonmaterial is sentient and absolute (unconditioned). Thus, sentient life is primitive and reproductive of itself – omne vivum ex vivo – life comes from life. This is the scientifically verified law of experience. Life is essentially cognitive and conscious. And, consciousness, which is fundamental, manifests itself in the gradational forms of all sentient and insentient nature. In contrast to the idea of objective evolution of bodies, as envisioned by Darwin and followers, Vedānta advocates the idea of subjective evolution of consciousness as the developing principle of the world. In this paper, an attempt has been made to highlight a few relevant developments supporting a sentient view of life in scientific research, which has caused a paradigm shift in our understanding of life and its origin.

• Darwinism
• artificial intelligence
• brain
• cell sentience
• consciousness
• machine
• mind
• organism
• origin of life
• teleology

• Allo-head and body reconstruction
• Allograft
• Head transplantation
• Mouse model
• composite tissue allotransplantation

• Body reconstruction
• Composite tissues allo-transplantation
• Head transplantation