The immunologic considerations in human head transplantation

Mark A. Hardy, Allen Furr, Juan P. Barret, John H. Barker

    Research output: Contribution to journalReview articleResearchpeer-review

    7 Citations (Scopus)

    Abstract

    © 2017 IJS Publishing Group Ltd The idea of head transplantation appears at first as unrealistic, unethical, and futile. Here we discuss immunological considerations in human head transplantation. In a separate accompanying article we discuss surgical, ethical, and psychosocial issues concerned in body-to-head transplantation (BHT) [1]. The success of such an unusual allograft, where the donor and the recipient can reject each other, depends on prevention of complex immunologic reactions, especially rejection of the head by the body (graft-vs-host) or probably less likely, the possibility of the head rejecting the total body allograft (host-vs-graft). The technical and immunologic difficulties are enormous, especially since rapid nerve and cord connections and regeneration have not yet been possible to achieve. In this article we begin by briefly reviewing neuro-immunologic issues that may favor BHT such as the blood brain barrier (BBB) and point out its shortcomings. And we touch on the cellular and humoral elements in the brain proper that differ in some respects from those in other organs and in the periphery. Based on recent successes in vascular composite allografts (VCAs), we will elaborate on potential specific advantages and difficulties in BHT of various available immunosuppressive medications already utilized in VCAs. The risk/benefit ratio of these drugs will be emphasized in relation to direct brain toxicity such as seizure disorders, interference, or promotion of nerve regeneration, and potentiation of cerebral viral infections. The final portion of this article will focus on pre-transplant immunologic manipulation of the deceased donor body along with pretreatment of the recipient.
    Original languageEnglish
    Pages (from-to)196-202
    JournalInternational Journal of Surgery
    Volume41
    DOIs
    Publication statusPublished - 1 May 2017

    Keywords

    • Composite tissue allotransplantation
    • Frontiers in surgery
    • Head transplantation
    • Reconstructive transplant surgery
    • Tolerance
    • Vascularized composite allografts rejection

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