World's First Human Spinal Cord Transplant Performed in Russia, Researchers Question Whether It Will Work
The world's first human spinal cord transplant has been completed in Russia. In the operation, three years after an injury, the damaged part of a person's spinal cord was removed and a section taken from a brain-dead donor was transplanted in its place. The information comes from a report in the science magazine New Scientist.
As of the writing of the report, the person was said to be well. However, the operation has raised concern among some researchers. They have questioned whether it will work at all, and they fear it could instead make the person's condition worse.
Xiaoping Ren of the Second Affiliated Hospital of Guangxi University of Chinese Medicine in China led the surgery. He told New Scientist the operation took place last week at the Sklifosovsky Institute for Emergency Medicine in Moscow.
Ren said the surgery was performed on an adult who had suffered a spinal cord injury three years earlier. Such injuries usually cause paralysis and loss of physical sensation below the injured site. However, exactly which part of the person's spinal cord was injured was not known.
Although detailed information is limited, Ren said the surgery used polyethylene glycol (PEG) — a kind of biological glue — alongside microsurgical techniques to join the ends of the donor section to the recipient's own spinal cord.
Ren said the patient had been informed in advance of every possible risk and outcome of the surgery, and that the patient's current condition is good. He also said their Russian team would later publish a document giving details of the surgery.
Sergio Canavero of Harbin Medical University in China's Heilongjiang province, who has previously published joint research papers with Ren on the possibility of human spinal cord transplantation, said this is a 'Sputnik moment' for spinal cord injury.
However, many have questioned whether the operation will actually help the recipient. Melissa Andrews of the University of Southampton in the UK said she is concerned about the patient's safety, because despite needing to recover from major surgery, the person will probably end up worse off after this process, while the benefit is very small. She also warned of a high risk of infection.
The biggest problem in repairing spinal cord injury is restoring communication between the brain and the neural circuits below the injured site. Spinal cord cells do not divide and do not regrow, and after an injury the damaged areas tend to deteriorate further.
For many years Ren, Canavero and other researchers have worked on a method in which freshly cut spinal cord surfaces are brought together and PEG is applied so the fibres at the junction can be fused. Using this technique, some improvement in movement has been seen in rats, dogs and pigs, the report also noted.
Michael Lebenstein-Gumovsky of the same Moscow institute has done similar work on pigs, although he was not involved in this human transplant. He has previously said the proposed fusion method is based on connecting nerves together rather than creating new nerve cells.
Andrew Jackson of Newcastle University in the UK said there is some evidence that PEG can help rejoin cut spinal cord nerves. But he also commented that joining two pieces of the adult nervous system together effectively is extremely difficult. He expressed hope that the supporting evidence for this surgery will be made available for expert peer review as soon as possible.
All told, this world's-first human spinal cord transplant speaks on one side of a new possibility in medical science, while on the other it has brought researchers' questions about safety and effectiveness equally to the fore. When the Russian team's promised detailed account is published, more information will be added to this debate.
